Footwear fit as a causal factor in diabetes‐related foot ulceration: A systematic review
Authors' conclusion
There is some evidence that IFF is a cause of DFU, but further research is needed, which defines IFF, and methodically records footwear assessment, ulcer location and physical activity. Researchers need to uncover why IFF is worn and if this is due to economic factors, a need for footwear education or other reasons.
Study context
- Population
- People with DFU; English-language peer-reviewed studies reporting DFU attributed to incorrectly fitting footwear (IFF), with physical examination of footwear worn10 studies
- Outcome
- Evidence that IFF is a statistically significant cause of ulceration
Methodological detailsrisk of bias assessed with Newcastle-Ottawa scale by two independent reviewers, 4318 results retrieved excluding duplicates; 45 shortlisted
- Risk of bias assessed with Newcastle-Ottawa scale by two independent reviewers
- 4318 results retrieved excluding duplicates; 45 shortlisted
Pooled result
As reported in the abstract
DFU associated with IFF
- Studies finding a statistically significant percentage of those with DFU wearing IFF or inappropriate footwear
- 3 of 10
- Percentage of those with DFU wearing IFF or inappropriate footwear (fastening, material, type or fit)
- 15.0%-93.3%
- Risk of bias in these three studies
- 'fair' to 'poor'
Further pooled results
IFF-related ulcer sites
- Plantar hallux/toes
- 70%
- Plantar metatarsal heads
- 10%
- Only one study reported
Risk of bias of included studies
- Fair
- 6
- Good
- 3
Original publication
Footwear fit as a causal factor in diabetes‐related foot ulceration: A systematic review. Diabet Med. Published 16 July 2024. doi:10.
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