DRWF Podcast: Early DRWF research support steps up diabetic neuropathy studies
People living with diabetes foot-related complications can hail “sock-cess” of recent innovations in footcare.
A “smart sock” for people with diabetes-related neuropathy is among several innovations currently being developed by Neil Reeves, Professor of Secure Health Technologies at Lancaster Medical School.
The pioneering healthcare technology for people living with diabetes is being developed as part of the NHS 10-year plan.
Healthcare technologies are central to the digital transformation promised by the NHS 10-Year Health Plan announced in January 2025, moving from “hospital to community; sickness to prevention; and analogue to digital”.
Professor Reeves and team at Lancaster University created the first sock measuring shear stress aimed at reducing the risk of foot ulcers for patients with.
The sock contains smart sensors to measure friction and alongside a foot screening app powered by AI (artificial intelligence).
For the latest episode of the DRWF Living with Diabetes podcast series, we talked to Professor Reeves about the smart sock and several other innovations currently being developed to improve the lives of patients with diabetes.
Professor Reeves previously carried out DRWF-funded research into the effect diabetic neuropathy has on people’s walking ability.
Professor Reeves said: “The DRWF-funded research was important in showing how diabetic neuropathy influences walking activities and contributes to unsteadiness and the risk of falls in people with diabetes.
“This is all part of a body of research that we are undertaking into the complications of diabetes and understanding how this influences walking function, unsteadiness, fall-risk and foot problems.
“Foot problems, diabetic neuropathy and unsteadiness are very closely linked and many people who have diabetic neuropathy may experience unsteadiness and will also need to take good care of their feet to avoid foot problems.”
Professor Reeves discovered that vibrating insoles in shoes can help improve gait and balance in people with diabetes. Because of peripheral nerve damage causing problems with balance, people with diabetes are up to 20-times more likely to fall compared to someone without diabetes.
Additional research by Professor Reeves demonstrated that wearing vibrating insoles for only 10 minutes improved walking quality to the same level as after six months of strenuous exercise training. This research is also of relevance for an ageing population.
Professor Reeves said: “We have got a few different research projects. One of the projects is called sock-cess, developing smart sensing socks for people with diabetes to try and reduce the risk of getting wounds on the foot, known as diabetic foot ulcers.
“Another project is around the use of diabetes-related health and medical technologies and the cyber security of these and understanding how we can improve the security of these kinds of digital technologies for diabetes.
“Both projects have been funded by Engineering and Physical Sciences Research Council (EPSRC), the main funding body for engineering and physical sciences research in the UK.”
The smart sock project developed socks with embedded sensors to help prevent diabetic foot ulcers. Providing foot pressure feedback to the patient has been shown to reduce diabetic foot ulcer incidence by more than 70%.
The project has now completed trials with diabetes patients and there is commercial interest from a private digital health company working in partnership with the NHS.
Professor Reeves said: “We have done quite a bit of work over the years with smart-sensing insoles. These are insoles that measure pressure under people's feet and feed that information back to people with diabetes who cannot feel their feet, who have not got any sensation.
“That helps to reduce the risk of those people developing a foot ulcer, a wound on the bottom of the foot. That research with smart-sensing insoles led us to this project with smart-sensing socks, because we saw two innovations, really that we needed to develop. One was the form factor in terms of the sock.
“We saw several advantages of people being able to use a sock for this purpose, rather than an insole. For example, socks fit in any types of shoes, whereas an insole has its limitations and it will not fit in certain shoes.
“The second innovation really that we addressed with this project, and the second need, is that all of the current technologies on smart-sensing insoles measure pressure under the feet, which is vertical pressure.
“With these socks we can measure something called shear pressure, or shear stress, which is essentially the rubbing movement that we get on the feet. This pressure and shear stress is important in the breakdown of the foot tissues and the causes of foot ulcers.
“The idea behind this project and this technology is that if we can provide this information back to people so they can see how much pressure and shear stress they are developing on their feet, they can modify that and hopefully reduce their risk of developing a diabetes-related foot ulcer.”
Around half the annual cost of the NHS is spent treating diabetes complications according to latest estimates, with one in four foot ulcers leading to amputation of all or part of the lower leg.
Professor Reeves said: “We know that many people with diabetes will go on to develop a foot ulcer in their lifetime. It is estimated that perhaps one quarter, or up to a third of people with diabetes will develop a foot ulcer at some point in their lifetime. This is a situation that can lead to infection, and it could lead to the need for amputation.
“The best approach is if we can avoid the development of these wounds, known as diabetic foot ulcers, in the first place. This kind of technology is all focused towards prevention. Preventing the foot ulcer, and preventing the wound before it develops.”
The technology could be seen as giving power back to people living with diabetes – in improving their risk of developing foot-related complications linked to the condition.
Professor Reeves said: “I think all of these technologies are about being able to give people more power to look after their own health. They are personal technologies and people can have the opportunity to take more ownership over their health. And hopefully that is a positive thing for people.”
Listen to the DRWF podcast interview with Professor Neil Reeves, part of the DRWF Living with Diabetes podcast series
Read more Stress-measuring smartwear in diabetes foot care is a “sock-cess” story
Read the DRWF diabetes information resource Foot health and diabetes
Read more about DRWF Research
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