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Smart Socks for People with Diabetes

  • Published: 2014-05-20 (Rev. 2016-11-01) - Contact: Thomas C. Weiss at Disabled World
  • Synopsis: Information regarding smart sock technology to help prevent foot ulcers and promote feet care for people with diabetes.

Definition: Defining the Meaning of Smart Socks

These socks use fiber optics and sensors to monitor temperature, pressure and joint angles in the feet, alerting medical professionals and wearers of the socks of any developing problems.

Main Document

"Every 20 seconds a limb is lost due to diabetes, but all of these amputations could be prevented."

Diabetes is a serious health issue and for people who experience diabetes, foot care can be a form of Achilles' heel, according to Dr. David Armstrong, Professor of Surgery at the University of Arizona.

Over time, people with diabetes lose their sense of pain and develop neuropathy. They may wear a hole in their foot in the same manner that others wear a hole in their shoe or sock says Dr. Armstrong. The statistics on diabetes and foot issues are stunning. As many as 25% of people with diabetes will develop a foot ulcer during their lifetimes and greater than half of those foot ulcers will become infected; 20% of those infections end up in an amputation.

Dr. Bijan Najafi, Associate Professor of Surgery at the University of Arizona and Director of the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP) states, "Every 20 seconds a limb is lost due to diabetes, but all of these amputations could be prevented. We need to find a smart way to predict the risk of diabetic foot ulcer and help patients to take care of their own health." Traditionally the best ways for people with diabetes to manage these issues has been to:

Socks for people with diabetes are usually designed to be form-fitting and seamless in order to eliminate any potential sources of irritation. The socks might have fibers with some anti-microbial or anti-fungal properties, yet for the most part their main purpose is to not make foot issues related to diabetes any worse. Yet what if a person with diabetes-related foot issues could prevent them before they happen

New products are available today and other ones are coming to market that have the potential to change the landscape for people with diabetes who are doing their best to take good care of their feet. Dr.'s Armstrong and Najafi work together at iCAMP, a subsidiary of the Southern Arizona Limb Salvage Alliance (SALSA), which recently received some large grants to study smart sock technology and its potential to be useful to people with diabetes. The socks they are studying are made with fiber-optics that can sense changes in pressure, temperature and joint angle and communicate the information through wi-fi or bluetooth to a person's phone or a medical provider's computer.

The 3 parameters; pressure, temperature and joint angle, are indicators of the potential development of ulcers. The smart socks provide the opportunity to provide more in-depth, real-time data about what is happening around a person's foot than has been available before. If successful, it is likely to save millions of dollars in health care costs because once an ulcer develops it may be very expensive and hard to manage. Dr. Najafi states, "If we can find a change of temperature in the plantar area, we can alert patients and doctors to do preventive care before the breakdown of skin or ulcer is happening."

At this time, Dr.'s Armstrong and Najafi are comparing data from smart socks with information gathered on people's feet through observation the old fashioned way. The goal is to differentiate what data gathered by the smart socks is relevant to appropriate foot care and what data might be considered, 'noise,' that might raise false alarms. Dr. Armstrong stated that the socks may reach the market within a year or two.

Cupron, Inc.'s PRO Therapy System

Chart showing the benefits of copper in smart socks
Chart showing the benefits of copper in smart socks

Smart socks are not the only exciting newcomers to the world of footwear for people with diabetes. A company called, 'Cupron, Inc.,' has developed a way of embedding a copper-oxide compound in polyester fibers and has created a line of socks called, 'PRO Therapy System,' with the goal of preventing foot ulcers. Chris Andrews, President of the company, says that copper does a couple of things:

Diabetes compromises a person's immune system and people with diabetes are more vulnerable to common infections than people in the general population. According to some studies, people with diabetes are up to 5 times more likely to contract a fungal infection and the consequences of those infections may be far more severe than would be typical. Mr. Andrews states, "The first benefit is that, as recognized by the EPA, the sock will kill the cause of Athlete's foot after twelve hours of contact with the sock. Effectively you're creating a sanitized surface in contact with the skin."

The sanitizing properties of the socks were why they were sent down a hole to a group of Chilean miners who were trapped for 68 days in the year 2010. Even though they have not been tested against all bacteria, fungi, and viruses, it is reasonable to expect that they would kill any of these present around a person's foot. Cupron, Inc. is hoping to gain Food and Drug Administration (FDA) sanction to market their smart socks to take care of all forms of foot bacteria, fungi and viruses. Mr. Andrews says, "If you're able to kill fungi, you're able to kill bacteria and viruses in a pretty straightforward manner. Fungi are probably the most difficult, as a rule."

Wearing copper-infused socks also has a beneficial effect on a person's skin elasticity, according to Mr. Andrews. The effect is important because when a person's skin is more elastic it has an increased ability to withstand the forces their feet regularly experience throughout their daily activities. He says, "If you can move from hard, brittle, static skin to softer, movable, more elastic skin, you're lowering the risk of rupturing the skin and leading to skin ulcers."

How the Smart Sock Works

The copper oxide in the sock is uniformly distributed throughout the polyester fibers. When someone wears the sock and their foot sweats (even just a little), the moisture causes the copper and the oxide to break apart and create free copper ions. The ions are then transported by the moisture to the person's skin - where they are absorbed either by the person's skin or by any fungi that are present on the person's skin. The process kills the fungi, or stimulates the person's skin cells called, 'fibroblasts,' which are the parts of the skin that generate new skin cells.

In an independent study, participants who wore the PRO Therapy socks over a period of 4 weeks showed skin elasticity improvement of 20-30%. There is also no need to worry about the socks running out of copper oxide - the process of wearing, and therefore wearing out the sock, continuously exposes more copper oxide. According to Mr. Andrews, the sock itself will fall apart before it will stop working.

Even though smart technology may advance diabetes foot care, podiatry experts continue to stress the tried and true methods used to prevent foot ulcers. Dr. Armstrong believes that visiting a podiatrist is even more important than using smart socks. According to Dr. Armstrong, the care of a podiatrist reduces a person's risk of complications by some 20-60% over a period of 6 years.

As new options for improved foot care become available on the market it might be necessary for people to recommend new treatments to podiatrists. Dr. Armstrong says that a number of foot doctors might not have heard of smart socks or other advances in foot care and may react with skepticism. The fact remains that the world of diabetes food care is on the verge of very real change.



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