Diabetic neuropathy is the number one cause of amputation in the world – and it affects as many as 70% of the 30 million-plus people in the US who suffer from diabetes, costing the economy as much as $10 billion annually. Diabetics with the condition suffer a loss of sensitivity in nerve endings in their legs and feet – meaning that, since they have less feeling in their feet they may end up damaging them extensively before they realized that they have a problem.
But a new invention developed jointly at Hebrew University and Hadassah Hospital – the SenseGo “smart sock” – could help temper the effects of diabetic neuropathy by offering a “sensor assist” to the feet.
With the SenseGo, “patients and their families get the tools they need to prevent the development of foot ulcers,” according to Prof. Yaakov Nahmias, head of the BioDesign: Medical Innovation program, where the socks were developed. “Thus we can dramatically reduce health care costs related to diabetes.”
Among the many health issues involved in diabetes is significant nerve damage that patients can experience. Scientists have known for years that high blood sugar levels can damage nerve endings. Studies show that even non-diabetic patients with high blood sugar levels complain of the tingling, “pins and needles” or burning sensations in the hands and feet — symptoms associated with neuropathy. The problem, of course, is much more severe in diabetics, who constantly struggle to control their blood sugar levels.
Feeling the pain
For reasons that are not completely clear, neuropathy tends to affect the feet first. And for diabetics, the ongoing loss of feeling in the feet could end up having disastrous consequences.
Although no one likes pain, it serves an important function in the body, telling us when we need to treat a wound, when there is excessive pressure that needs attention, etc. In the feet, those pains could result from actual injury, too-tight shoes, incorrect posture leading to excessive pressure on a sensitive part of the foot, and other causes. Failure to treat these issues could eventually lead to problems like foot ulcers, sores or wounds that refuse to heal – a special problem for diabetics, whose ability to heal themselves is already compromised because of their blood circulation problems.
Once an ulcer develops, it is often late in the game – and even with treatment, irreparable damage may have been done, according to Danny Bavli, lead engineer of the SenseGo development group.“This is a significant medical problem that affects the lives of millions,” said Bavli. “We thought there must be a way to avoid these wounds altogether.”
Sensor technology to the rescue: In the SenseGo system, dozens of micro-fabricated pressure sensors built into the sock monitor issues that could cause foot problems for diabetics. Incorrect posture, anatomical deformation or even pressure from ill-fitting shoes are registered as electrical signals that are relayed to a smartphone app, which in turn informs the patient of developing risk. The sensors in effect replace the nerves that have been damaged, providing patients with data on the pain they should be feeling – but aren’t.
Perhaps the most unique thing about SenseGo socks is that they are washable – the result of materials research conducted at Hebrew U as well. Bavli partnered with Sagi Frishman and Dr. David Morgenstern, a leading orthopedic surgeon at Hadassah Medical Center, to develop the sensor system. Integrated with the materials technology that enables electronic sensors to stand up to a thorough washing, the team developed a prodict that it believes will make the lives of diabetics significantly better – and healthier.
“The novelty of our technology is the 3D organization of the sensors, which is important for clinical problems where the foot deforms over time,” said Nahmias. “This is a classic mobile health approach to reduce health costs.”