Skip to main content
Log in

Design and manufacturing a smart shoe for diabetic foot ulcer monitoring and prediction system using internet-of-things technology

  • Technical Paper
  • Published:
Journal of the Brazilian Society of Mechanical Sciences and Engineering Aims and scope Submit manuscript

Abstract

Prediction of diabetic foot ulcer outcome is helpful for clinicians in optimizing and individualizing management strategy. Diabetic foot ulcer (DFU) is one of the important complication of diabetes, which is occurred due to the destructive parameters in different locations of the foot. In order to decrease or prevent the formation of the diabetic foot ulcer at very early stages, we proposed in this paper an monitoring and control system using wirelessly controlled device that predicts the DFU before the occurrence; this system is designed for diabetic patients for daily monitoring, as it reduces frequent visits to the doctor and prevents complications that may include amputation or death in the worst cases and reduce the cost of treatment as well. A flexible insole is designed consisting of multiple type of non-invasive sensors, these sensors monitor different vital parameters (temperature, humidity, plantar pressure, and oxygen saturation in the blood), and these sensors are distributed on a flexible insole inside the shoe to monitor the sole of the foot. When these vital parameters exceed the threshold limit, the system sends an alert to the patient via a graphical user interface (GUI) using Internet-of-Things technology (IoT). It was found that the difference in temperature between the ulcerated foot as a result of high temperature and humidity and the healthy foot is 2.27 °C where it reached 38 °C, and the relative humidity values exceeded the normal limit to reach 74%. In the case of ulcers resulting from an increase in the values of plantar pressure on the foot and its recurrence, a decrease in the average values of oxygen saturation in the blood was observed, where its value decreased to 93.44%, where was the highest value of the plantar pressure 448.28 kpa. The system also demonstrated efficiency in response time and data processing speed, with a time delay of 1.5–2.5 s, depending on the Wi-Fi network's quality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Fard A, Shojaie ME, Larijani B (2007) Assessment and treatment of diabetic foot ulcer. Int J Clin Pract 61(11):1931–1938

    Article  CAS  PubMed  Google Scholar 

  2. Rasmussen BSB et al (2015) A randomized controlled trial comparing telemedical and standard outpatient monitoring of diabetic foot ulcers. Diabetes Care 38(9):1723–1729

    Article  PubMed  Google Scholar 

  3. Lim JZ, Ming NS, Ng L, Thomas C (2017) Prevention and treatment of diabetic foot ulcers. J R Soc Med 110(3):104–109

    Article  PubMed  PubMed Central  Google Scholar 

  4. Al-Rubeaan K et al (2015) Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS ONE 10(5):e0124446

    Article  PubMed  PubMed Central  Google Scholar 

  5. Brownrigg JRW, Schaper NC, Hinchliffe RJ (2015) Diagnosis and assessment of peripheral arterial disease in the diabetic foot. Diabet Med 32(6):738–747

    Article  CAS  PubMed  Google Scholar 

  6. Doulamis A et al (2021) A non-invasive photonics-based device for monitoring of diabetic foot ulcers: architectural/sensorial components & technical specifications. Inventions 6(2):27

    Article  Google Scholar 

  7. Viswanathan V, Kumpatla S (2011) Pattern and causes of amputation in diabetic patients—a multicentric study from India. J Assoc Phys India 59(3):148–151

    Google Scholar 

  8. Dmitriyeva M et al (2021) Monitoring and prevention the risk of diabetic foot ulcer infection during coronavirus disease-19 pandemic: a narrative review and perspective algorithm. Open Access Maced J Med Sci 9:577–582

    Article  Google Scholar 

  9. Subramaniam S et al (2022) Insole-based systems for health monitoring: current solutions and research challenges. Sensors 22(2):438

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  10. Yazdanpanah L, Nasiri M, Adarvishi S (2015) Literature review on the management of diabetic foot ulcer. World J Diabet 6(1):37

    Article  Google Scholar 

  11. Sandoval-Palomares JDJ, Yáñez-Mendiola J, Gómez-Espinosa A, López-Vela JM (2016) Portable system for monitoring the microclimate in the footwear-foot interface. Sensors 16(7):1059

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  12. Abbott CA et al (2022) Site-specific, critical threshold barefoot peak plantar pressure associated with diabetic foot ulcer history: a novel approach to determine DFU risk in the clinical setting. Medicina 58(2):166

    Article  PubMed  PubMed Central  Google Scholar 

  13. Armstrong DG et al (2007) Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. Am J Med 120(12):1042–1046

    Article  PubMed  Google Scholar 

  14. Jeffcoate WJ, Harding KG (2003) Diabetic foot ulcers. The lancet 361(9368):1545–1551

    Article  Google Scholar 

  15. Brooks E et al (2021) Remote diabetic foot temperature monitoring for early detection of diabetic foot ulcers: a cost-effectiveness analysis. Clinicoecon Outcomes Res CEOR 13:873

    Article  Google Scholar 

  16. Kavitha KV et al (2014) Choice of wound care in diabetic foot ulcer: a practical approach. World J Diabet 5(4):546

    Article  Google Scholar 

  17. Benbakhti Anwar S et al (2014) An instrumented shoe for ambulatory prevention of diabetic foot ulceration. In: 2014 4th International conference on wireless mobile communication and healthcare-transforming healthcare through innovations in mobile and wireless technologies (MOBIHEALTH). IEEE

  18. Anand S et al (2011) Clinical applications of diffuse reflectance spectroscopy in normal and prediabetic subjects-a pilot study. In: 2011 Defense science research conference and expo (DSR). IEEE, 2011

  19. Interlink electronics, "FSR® 400 series data sheet", FSR® 402

  20. Maxim Integrated (2018) High-sensitivity pulse oximeter and heart-rate sensor for wearable health. Nr. 19-7740; Rev 1; 10/18

  21. Sensirion the sensor company (2010) Datasheet SHT21 humidity and temperature sensor. Nr. 347386, Vr.0.1

  22. Boulton AJ, Meneses P, Ennis WJ (1999) Diabetic foot ulcers: a framework for prevention and care. Wound Repair Regen 7(1):7–16

    Article  CAS  PubMed  Google Scholar 

  23. Twilley H, Jones S (2016) Heel ulcers–pressure ulcers or symptoms of peripheral arterial disease? An exploratory matched case control study. J Tissue Viability 25(2):150–156

    Article  PubMed  Google Scholar 

  24. Mantey I et al (2000) Infection of foot ulcers with staphylococcus aureus associated with increased mortality in diabetic patients. Commun Dis Public Health 3:288–290

    CAS  PubMed  Google Scholar 

  25. Wilkoff LJ, Westbrook L, Dixon GJ (1969) Factors affecting the persistence of staphylococcus aureus on fabrics. Appl Microbiol 17(2):268–274

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Najafi B et al (2012) Plantar temperature response to walking in diabetes with and without acute Charcot: the Charcot activity response test. J Aging Res 2012

  27. Ramirez-Bautista JA et al (2017) A review in detection and monitoring gait disorders using in-shoe plantar measurement systems. IEEE Rev Biomed Eng 10:299–309

    Article  PubMed  Google Scholar 

  28. Liu M et al (2017) Low-power, noninvasive measurement system for wearable Ballistocardiography in sitting and standing positions. Comput Ind 91:24–32

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rafal F. Ghazi.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of the interest regarding the publication of this paper.

Additional information

Technical Editor: Adriano Almeida Gonçalves Siqueira.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ghazi, R.F., Chiad, J.S. & Abdulghani, F.M. Design and manufacturing a smart shoe for diabetic foot ulcer monitoring and prediction system using internet-of-things technology. J Braz. Soc. Mech. Sci. Eng. 46, 83 (2024). https://doi.org/10.1007/s40430-023-04591-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40430-023-04591-2

Keywords

Navigation