Custom-Made Footwear Boosts Adherence in High-Risk Diabetes Patients
An early report from the DIASSIST trial, published June 21, 2025 on DiabeticFootOnline, explores whether a multi-modal intervention can improve adherence to custom-made footwear in individuals at high risk for diabetic foot ulceration.
Key Highlights:
- Behavioural Strategy: The intervention paired structured education (using the Fragile Feet–Trivial Trauma model), motivational interviewing via phone, and custom-made indoor footwear.
- Study Participants: 53 people with healed ulcers and prescribed custom footwear were monitored for usage via embedded sensors; 57% had low adherence at baseline (<8 hours/day).
- Education Boost: Structured education led to a clinically meaningful increase in wear time (~+1 hr/day), though this did not reach statistical significance.
- Limited MI Impact: Motivational interviewing did not significantly affect adherence in this short-term evaluation.
- Footwear Matters: Custom indoor footwear produced a significant jump in wear time—+2.7 h/day for low adherence users and +2.0 h/day for high adherence users (p < 0.01).
Although the combined approach didn’t yield statistically significant overall changes at 3 months, the immediate and meaningful increase from indoor footwear highlights its potential as an effective, easy-to-implement measure in ulcer prevention protocols.
Based on Van Netten et al., “Short‑Term Efficacy of a Multi‑Modal Intervention Program to Improve Custom‑Made Footwear Use in People at High Risk of Diabetes‑Related Foot Ulceration,” J Clin Med, 2025;14(11):3635.
Keywords: custom footwear, footwear adherence, diabetic foot ulcer, education intervention, indoor footwear