In Europe, an estimated 59 million people live with diabetes and this number is growing rapidly. Diabetes and its lower extremity complications such as neuropathy, are a leading cause of amputation, hospitalisation, reduced mobility, loss of social participation, and lower quality of life. These amputations are nearly always preceded by a foot ulcer. While there are various general treatment approaches to help prevent these foot ulcers, their incidence remains high, up to 40% within one year for people who have healed from a foot ulcer. DIALECT is the Diabetes Lower Extremity Complications Research and Training Network in Foot Ulcer and Amputation Prevention and aims to deliver the next generation of scientists with the expertise, skills and experience to successfully combat diabetic foot disease and its devastating consequences.
DIALECT focusses on five key objectives (within 3 research work packages) to improve treatment in ulcer and amputation prevention, taking a personalised treatment approach;
1. Establish a new risk stratification model to stratify patients at high risk for diabetic foot disease and to guide personalised medicine in foot ulcer and amputation prevention (Model)
2. Conduct beyond state-of-the-art biomechanical analyses to formulate new hypotheses on specific diabetic foot conditions and pave the way for personalised medicine in ulcer prevention (Model)
3. Establish beyond state-of-the-art physical activity and treatment adherence profiles using artificial intelligence to formulate new hypotheses on patient behaviour in diabetic foot disease (Measure)
4. Develop technologically advanced sensor system products for laboratory measurements and personalised at-home monitoring of foot(wear) biomechanics, activity, and adherence in diabetic foot disease (Measure, Make)
5. Make and validate beyond state-of-the-art personalised footwear using machine learning applications to improve biomechanical, activity, and adherence outcomes in foot ulcer and amputation prevention (Make)
The results of the DIALECT program will improve the personalized treatment approach for people with diabetes who are at moderate to high risk of developing foot disease. People with the disease will be better classified according to their risk of ulceration, we will better understand particular pathologies of the diabetic foot, we will be able to better monitor people for relevant biomechanical outcomes and we will deliver footwear that will better fit the patients foot and distribute pressure on the foot. With this personalised more data-driven approach to ulcer and amputation prevention a large impact is expected in reducing the patient and society burden of diabetic foot disease.
