Evidence map›Paper›PMID 41706181›Full record

ArticleActa diabetologica2026

Current strategies and priorities for diabetic footwear design and production: a cross-European exploratory survey of clinicians and shoemakers.

Hadi Sarlak, Kamran Shakir, Giulia Rogati, Alberto Leardini, Lisa Berti, Paolo Caravaggi

Abstract read
In one paragraph

Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hadi SarlakDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Via Zamboni,33, Bologna, 40126, Italy.ORCID http://orcid.org/0000-0002-4775-7057
Kamran ShakirDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Via Zamboni,33, Bologna, 40126, Italy. kamran.shakir2@unibo.it.ORCID http://orcid.org/0009-0008-8978-7992
Giulia RogatiMovement Analysis Laboratory and Functional Evaluation of Prostheses, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna, 40136, Italy.ORCID http://orcid.org/0000-0001-9301-9461
Alberto LeardiniMovement Analysis Laboratory and Functional Evaluation of Prostheses, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna, 40136, Italy.ORCID http://orcid.org/0000-0003-3547-7370
Lisa BertiDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Via Zamboni,33, Bologna, 40126, Italy.
Paolo CaravaggiMovement Analysis Laboratory and Functional Evaluation of Prostheses, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna, 40136, Italy.ORCID http://orcid.org/0000-0002-8994-8062

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTherapeutic footwear plays an important role in preventing ulceration in people with diabetes. Despite guidelines recommending offloading footwear for individuals at risk of ulceration, limited data are available on the alignment between current industrial practices, clinical expectations, and evidence. This study explored current practices, priorities and challenges associated with diabetic footwear from manufacturers’ and clinicians’ perspectives across Europe.

methodsAn exploratory cross-sectional survey was conducted between May and October 2025 to gather insights from diabetic footwear manufacturers and clinicians involved in diabetic foot care across Europe. A 26-item questionnaire was developed to explore product design, materials, innovation, and adherence to guidelines among manufacturers. Additionally, a separate 14-item questionnaire for clinicians examined footwear prescription, patient barriers, and industry communication. Quantitative data were analysed descriptively, and open-text responses underwent thematic analysis.

resultsNine manufacturers and twelve clinicians participated in the survey. While only half of the Manufacturers that completed the survey reported having a research and development department, most reported adopting data-driven design approaches (n = 8) and scientific literature (n = 7). Offloading, internal volume, and toe protection were the highest-ranking priorities for manufacturers, whereas aesthetics ranked lowest. Clinicians, conversely, prioritised accommodation of deformities, offloading, and comfort, and highlighted poor aesthetics and shoe weight as major limitations to adherence.

conclusionsThis exploratory study suggests partial alignment between diabetic footwear manufacturers and clinicians on functional and offloading features but highlights gaps in aesthetics, materials, and sustainability. Better collaboration, data-driven innovation, and clearer product specifications could improve user adherence, prescription efficacy, and the preventive role of therapeutic footwear in diabetes care.

Indexed as

Diabetic FootEquipment DesignShoesCross-Sectional StudiesEuropeHumansSurveys and QuestionnairesDiabetic foot ulcersFootwear designOffloadingSurveyTherapeutic footwear

Identifiers

PMID41706181
PMCPMC13219091

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.