Abstract : One of the main symptoms of diabetes mellitus
patients is the lack of feeling in their feet. The lack of protective pain
perception means that diabetics can easily develop foot ulcers, which can lead
to amputation. Diabetics have a 20 times greater risk of foot amputation. Now an
IST project, Diafoot has developed an enhanced method of monitoring diabetic
patients' feet using advanced data logging and communication technologies.
With some 50 to 60 million people across Europe likely to suffer type 2 diabetes
in the coming years, the resulting impact on the economy of national health
services can be severe. The partners in Diafoot have developed a system for
remote monitoring of patients' feet, not just within the clinic but while they
go about their everyday lives. Using a specially designed insole with embedded
measuring devices, the system is capable of monitoring pressure at various
points on the soles of the feet, foot temperatures and humidity.
This data is logged using small portable devices that patients wear on their
clothing, and which can then be connected to a PC or mobile phone to upload the
data to the clinic for further analysis.
Advantages for both patient and clinic According to project manager Enrique Montiel Parreno, of INESCOP in Alicante,
this new technology represents a significant advance on earlier systems. "Diafoot
is a true monitoring system compared to other products which are solely for
diagnostic use within the clinic. We can now monitor patients in real-life, and
measure the pressures on different areas of their feet as they go about their
daily activities."
The second key advantage, he believes, is the improvement in the clinical
support offered. "We can correlate all this data with the efficiency of the
insole design. We can examine the efficiency of the materials used to
manufacture the insole, and refine the design and specifications to improve the
protection these insoles offer to patients."
For the diabetic patient, the advantages of the system are very real. At
present, diabetics have to visit the hospital regularly every 45 and 60 days,
and during this period no information about possible problems is available until
the next visit. Now they can enjoy extended periods without direct visits, using
the Diafoot system to update the clinician on their progress.
Health providers also benefit. Diafoot is expected to reduce the number of
amputations required by around 20 per cent, which apart from the human cost
could mean a saving for healthcare services of 30,000 euros per patient in minor
amputations and 60,000 euros in major amputations. In addition, the savings in
costs of prosthesis manufacture, rehabilitation and associated hospitalisation
expenses should be factored in. Such savings in treatment costs directly impact
the efficacy of the hospital management budget.
Integrating different technology elements The technology behind Diafoot is based on integrating a number of separate
elements to provide new procedures for the remote monitoring of patients with
diabetes, as well as new sensor and data acquisition/analysis techniques. The
key elements are:
Specific micro-sensor systems that are non-aggressive both
to the human foot and as regards radio frequency.
Temporary data-logger units that store the appropriate data
files.
A base unit, that link the data-logger via TCP/IP, modem,
GSM and/or GPRS to the central service.
A central server at the clinic for data input, storage and
analysis.
The various project partners have all played their part in
the design and development of the system. They include the Virgen del Consuelo
Clinic, part of the Nisa Hospital Group in Valencia; the Miguel Hernandez
University in Elche; the University of Pisa and the CGS industrial consultancy
in Pisa. Clinicians at these organisations are now involved in testing the
system on patients and finding ways to further refine the technology.
Results will influence footwear designs The technologies developed in Diafoot can bring an enormous benefit to
diabetic patients in terms of continuous monitoring and consequent improved
support from clinics. However the results of the project have also contributed
towards the creation of a standard diabetic foot protocol, based on the use of
telematic applications and a wider coverage of at-risk patients (some 25 per
cent of all diabetic patients) .
Diafoot results are also highly relevant to the insole manufacturers, and are likely to influence existing materials and footwear
as well as those products designed to meet the specific requirements of
individual patients.
Subject Descriptors : Information processing, Information
retrieval, Information transmission
Subject Index Codes : Information Processing, Information Systems
Subject Class : IT, telecommunications
Remarks : Results Entry form
Collaboration Sought : Further research or development support, Information
exchange/Training
Sources of Support : CEC
Programmes : IST
Projects : IST-2001-33281
Project Title : Remote Monitoring Of Diabetic Feet
Contact Details
Contact Name : MONTIEL PARRENO, Enrique (Professor)
Contact Organisation : Instituto Espanol del Calzado y Conexas - INESCOP
Address : Poligono Industrial Campo Alto
City : Elda
Region : ESTE
COMUNIDAD VALENCIANA
Alicante
Postcode : 03600
Country : SPAIN
Telephone Number : +34-96-5395213
Fax Number : +34-96-5381045
Electronic Mailbox : emontiel@inescop.es
