Faculté de médecine Faculté de médecine

Diabetic Foot

The research group led by Prof. Zoltan Pataky at the University Hospitals of Geneva (HUG) and the University of Geneva (UNIGE) is dedicated to improving the quality of life and clinical outcomes for people living with diabetes, particularly those at risk of severe complications like diabetic foot ulcers and amputations. Recognising that foot ulcers remain one of the most devastating and costly complications of diabetes, Prof. Pataky’s team has focused its efforts on innovative, technology-enabled solutions for prevention.

The group is spearheading the development of an intelligent, pressure-redistributing shoe—a novel, wearable medical device designed to dynamically offload plantar pressure in real time. The project, officially known as IOF (Intelligent Offloading Footwear), is a multidisciplinary collaboration involving clinical researchers from HUG and engineers from EPFL, and industrial partner Giglio Orthopédie SA. The project is supported by SNSF Bridge Discovery grant, Innosuisse Swiss Innovation Agency grant and most recently SNCF Div. III grant. The project integrates biomechanical research, sensor technology and user-centered design to address a critical unmet need in diabetic foot care. The IOF not only monitors plantar pressure but also responds autonomously, adjusting its structure to reduce pressure in high-risk areas—thus preventing tissue breakdown and, ultimately, amputations.

With clinical trials underway and early data showing promising reductions in peak pressure, the project positions the team at the forefront of digital and precision medicine in diabetes care.

RESEARCH AIMS

The primary aim of our research is to prevent diabetic foot ulcers and lower-limb amputations through the development of an intelligent, adaptive footwear system that provides real-time offloading of plantar pressure.

Despite well-established guidelines for offloading, adherence to passive offloading footwear remains low due to discomfort, aesthetic limitations, and lack of adaptability.

To address these gaps, the IOF (Intelligent Offloading Footwear) project is pursuing the following research objectives:

  1. Design and engineer a smart footwear system that integrates embedded pressure sensors and dynamic actuators to monitor and modulate plantar pressure in real time. This involves developing an adaptive midsole and insole system that responds autonomously to pressure distribution while walking.
  2. Validate the biomechanical performance and clinical utility of the intelligent shoe through rigorous gait analysis and real-world clinical trials. The goal is to demonstrate not only pressure redistribution but also improvements in patient-reported outcomes, including comfort, adherence, and quality of life.
  3. Ensure user-centered design and scalability by incorporating feedback from people with diabetes and healthcare providers throughout the development process. This participatory approach aims to produce a solution that is medically effective, acceptable to patients, and compatible with real-world clinical workflows.

Through these research goals, the team aims to set a new standard in diabetic foot care, shifting from reactive wound management to proactive, intelligent prevention.

CORE EXPERTISE

·       Diabetic Foot Biomechanics:  We conduct advanced gait analysis and plantar pressure assessments to understand how mechanical stress contributes to foot ulceration. This biomechanical insight underpins the development of responsive offloading strategies tailored to individual walking patterns and foot anatomy.

·       Wearable Sensor Integration : Our team designs and tests embedded pressure sensors that capture real-time foot-loading data with high spatial and temporal resolution. These sensors form the foundation of the IOF, enabling accurate, continuous monitoring in everyday conditions.

·       Translational Clinical Research:  With direct access to patients and interdisciplinary care settings at the HUG, our team designs and executes proof-of-concept and feasibility trials, integrating patient-reported outcomes and functional measures.

·       User-Centered Co-Design: Our development process incorporates feedback from people with diabetes, clinicians, and podiatrists. We prioritize usability, comfort, and aesthetics alongside clinical efficacy to ensure that the final product supports real-world adherence and lifestyle integration.

·       Multidisciplinary Collaboration: We work closely with academic engineering partners (EPFL), orthotic manufacturers (Giglio Orthopédie SA), and innovation stakeholders (e.g., Innosuisse, SNSF) to foster a truly translational and scalable innovation pathway.

SELECTED PUBLICATIONS

2 Jul 2025

Research