Diabetes rates have risen sharply in developed countries in the wake of the obesity epidemic, and an estimated 30 million Europeans live with the condition. Foot problems are the most common cause of admission to hospital for diabetics, who are at risk of serious complications such as nerve damage and problems with the blood supply to their feet. Both conditions can lead to slow-healing wounds and foot ulcers which, if they get infected and become gangrenous, can lead to amputation.
According to the International Diabetes Federation, most cases of foot ulcers and amputations can be prevented by good foot care and wearing appropriate, properly fitting shoes that don’t rub the feet or create pressure spots. Studies show that unsuitable footwear contributes to a significant increase in foot complications and is linked to 60-80% of all cases of foot damage.
The idea for EUREKA Project E! 2923 DIASHOE came from Professor Petr Hlavacek, Head of the Institute of Proteins and Leather Technology at the Tomas Bata University in the Czech Republic. He approached Czech footwear manufacturer and retailer Bata to suggest collaborating on developing a new generation of affordable prophylactic footwear for diabetics, designed to protect their feet and slow down and prevent unnecessary or irreversible damage.
Led by Bata, the four-year project pulled together the expertise of university researchers, diabetes experts and orthopaedic footwear specialists from the Czech Republic, Austria, Germany and Italy.
Getting the measure of the problem
The design and development phase of the project involved developing a prototype shoe last, along with specialised soles, insoles and antibacterial linings. Constructing and refining the shoe last required, for comparison purposes, analysis of the feet of both diabetics and non-diabetics, plus thousands of meticulous measurements which were performed by researchers and students at the Tomas Bata University.
The team experimented with different materials to formulate soles with varying degrees of flexibility and support for differing degrees of foot impairment, and protecting specific pressure points when walking. Italian orthopaedic footwear specialist Maria Clara developed and tested a model featuring an elasticised fabric upper section for diabetics unable to wear leather shoes owing to advanced deformities. Good foot hygiene being especially important for diabetics, the team also spent some time developing and testing insoles and determining the most effective antibacterial treatment for the lining materials.
Rapid progress to market
Clinical trials took place over two years in Austria and the Czech Republic to test the DIASHOE prototypes manufactured by Bata. The diabetic volunteers recruited exhibited a range of foot complications, from non-serious complaints to functional problems arising from ulcers and amputations. “The clinical trials confirmed the footwear’s prophylactic efficacy, and we received excellent feedback from the test subjects,” says project manager Jana Vaskova. “The prototypes also proved equally suitable for non-diabetics with other orthopaedic conditions or who had undergone foot surgery, and for older people.”
Today, the range of footwear is available on sale in Bata stores, pharmacies and orthotic shops selling medical devices, marketed under the brand name MEDI. “First of all a diabetic customer has to have his or her feet assessed and measured by their diabetes consultant or clinic, who will provide a prescription for their exact requirements which they bring along to one of our stores,” explains Vaskova. ”The MEDI range has the right shoes for most diabetics – the fact that they aren’t custom-made is what makes them affordable. The footwear is also officially accredited as a medical product, so a customer may also be able to reclaim the cost from their medical insurers.”
Manufactured in Europe
MEDI footwear is manufactured by Bata’s own factory in the Czech Republic. “Most footwear is produced in China these days, but manufacturing it ourselves ensures the shoes are of superior quality,” says Vaskova. “We can also produce in smaller quantities, and can respond more quickly and flexibly to orders from our stores and directly from customers. MEDI is selling well – customers usually buy several pairs!”
The MEDI range is currently available in the Czech Republic, Austria, Germany, Poland, Hungary and Slovakia. For the time being, distribution to other countries is limited by adverse currency exchange rates, but with more than 180 million diabetics worldwide according to World Health Organization statistics, the potential market for this diabetic-friendly range of footwear is significant.
Giving diabetics added value
EUREKA’s endorsement and support for project DIASHOE, which included funding for the Czech partners, was invaluable, according to Vaskova. “Project DIASHOE was instrumental in providing us with the information and collaboration we needed to develop a commercial range of shoes capable of improving a diabetic’s quality of life and minimising the risk of debilitating complications.
“Additional outcomes of the project are the educational brochures and films we have produced and distribute to patients via doctors and clinics and diabetes associations that explain the importance of taking good care of their feet and wearing the right kind of shoes.”
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