Hadi Sarlak1,2 · Kamran Shakir1,2 · Giulia Rogati2 · Alberto Leardini2 · Lisa Berti1,3 · Paolo Caravaggi2
Received: 11 December 2025 / Accepted: 5 February 2026 © The Author(s) 2026
Abstract
Background Therapeutic footwear plays an important role in preventing ulceration in people with diabetes. Despite guide-lines 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.
Methods An 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 communica-tion. Quantitative data were analysed descriptively, and open-text responses underwent thematic analysis.
Results Nine 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 defor-mities, offloading, and comfort, and highlighted poor aesthetics and shoe weight as major limitations to adherence.
Conclusions This 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.
Keywords Diabetic foot ulcers · Therapeutic footwear · Offloading · Survey · Footwear design
Communicated by Massimo Federici.
Kamran Shakir
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Hadi Sarlak
Giulia Rogati
Alberto Leardini
Lisa Berti
Paolo Caravaggi
1 Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Via Zamboni,33, Bologna 40126, Italy
2 Movement Analysis Laboratory and Functional Evaluation of Prostheses, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, Bologna 40136, Italy
3 Physical Medicine and Rehabilitation Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna 40136, Italy
Jolanta Szeliga-Krol1 · Agata Betlejewska1 · Monika Buraczynska1 · Wojciech Zaluska1
Received: 29 September 2025 / Accepted: 25 January 2026 © The Author(s) 2026
Aims Our study aimed to evaluate the association between the erythropoietin gene rs1617640 polymorphism and diabetic retinopathy (DR) in diabetes patients.
Methods In this preliminary retrospective study the genotyping was performed on 860 DNA samples from Caucasian patients with type 2 diabetes mellitus (T2DM). For analyzing the effect of the polymorphism, patients were assigned into three phenotypic subgroups: non-DR (without retinopathy), NPDR (with non-proliferative diabetic retinopathy) and PDR (with proliferative diabetic retinopathy). The rs1617640 polymorphism was analyzed using polymerase chain reaction (PCR)–restriction fragment length polymorphism (RFLP) and direct DNA sequencing procedures.
Results A statistically significant difference in the polymorphism distribution was observed between T2DM patients with DR (both NPDR and PDR) and those without DR. The minor G allele was associated with the increased risk of DR. In the NPDR subgroup subjects carrying the G allele had 1.53-fold higher risk of developing retinopathy. Similarly, in the PDR subgroup patients carrying the G allele showed almost twofold increased risk of PDR in a dominant model of inheritance.
Conclusion Our results demonstrate that in T2DM patients the EPO rs1617460 polymorphism is associated with signifi-cantly increased risk of developing DR. This finding can provide a new insight into the role of EPO gene in the pathophysi-ology of microvascular complications of diabetes.
Keywords EPO gene · Type 2 diabetes mellitus · Diabetic retinopathy · Single nucleotide polymorphism · Risk allele
Communicated by Marta Letizia Hribal.
Monika Buraczynska 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。
1 Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-950 Lublin, Poland
佛山市禅城区中心医院慢性伤口造口专科主任。
内分泌代谢学博士。教授、主任医师、博士生导师。
南方医科大学第三附属医院副主任医师 硕士导师 医学博士
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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