INTELLIGENT DIABETIC SOCKS : Embedded Device for Diabetic Foot Prevention – IDS

PATHOLOGICAL CONTEXT:
Diabetic Foot is the consequence of the long-term chronic complications of diabetes affecting the lower limbs, namely peripheral neuropathy and angiopathy. When both complications are associated to an external trivial trauma, they determine the progression of the pathology from a non-ulcerated condition of a foot at risk, to an acute syndrome characterised by the classic diabetic foot ulcer, followed by a chronic condition in the post-ulcerative phase, which can lead to amputation.

SOCIETAL AND ECONOMICAL CONTEXT:
A limb is lost every 30 seconds on planet Earth because of diabetes. In addition to causing pain and morbidity, foot lesions in diabetic patients have substantial economic consequences: $11 billion and £3 billion respectively from US and UK health expenditures both in 2001. However, in addition to the direct costs of foot complications, there are also indirect costs relating to loss of productivity, individual patients and family costs and loss of quality of life.

EFFECTIVENESS OF PREVENTION:
Studies have suggested that follow Team Care behaviour could reduce foot ulcer and amputation from 50% to 80%. This monitoring strategy is largely based on renewed vigilance of the diabetic patient which mainly consists in making a daily inspection of his feet. Unfortunately, studies have shown that patient vigilance decreases over time. Complications which appear after some time are directly correlated with the increasing lack of vigilance. Other studies have provided insoles prototypes based on a real time measurement of the pressures between the plantar foot and the shoes but they are developed in the context of gait analysis and need a wire connection between the insole and an electronic acquisition card. Moreover, these prototypes are unable to detect overpressures in the dorsal surfaces of the toes and the feet.
That is why IDS (Intelligent Diabetic Socks) project proposes to develop the first smart wearable device able to monitor and assist the diabetic patient to help him maintaining alertness against foot overpressures both in real-time and in a daily use.

ORIGINALITY, INNOVATIONS AND AMBITIOUS NATURE OF THE IDS PROJECT:
Originality and innovations of the IDS project lie in the final wearable device, the Intelligent Diabetic Socks, dedicated to real-time foot ulcers prevention for diabetic people. This scientific and technological innovation, based on a textile able to measure pressure, will alert the patient as soon as overpressures and/or internal stresses are observed in the foot or the ankle. In addition to this warning, some advices concerning ways to reduce the corresponding risks will be proposed to the patient. Once warning validated by the patient, the device provides recommendations through a media like the "smart phone" (or a "watch") that is able to deliver simple messages like “Stop as soon as possible”, “Remove the pebble in your shoe” or more elaborate ones like the display of the full pressure cartography. The ambitious nature of the project lies in the discretion and the comfort of the IDS device. First with a diabetic sock which looks like any other sock, but also with a real-time measurement of pressures and stresses that can generate very simple alerts or more complex messages. After consulting the information transferred to his smart phone, the patient will be able to see areas that were most pressurized during the day. In particular are highlighted the areas that the patient can check himself or the areas to be treated promptly by his doctor.

RELEVANCE OF THE PROPOSAL IN RELATION TO THE CALL THEME:
The IDS project both concerns the principal focus of the call theme about development of innovative technologies and services for functional substitution of impairment and for autonomy in general and the priority focus of the call theme about development of innovative technologies and services to favour autonomy of patients with chronic diseases.