A two-year study published in The Journal of the American Medical Association on May 15, has cast doubt on the effectiveness of therapeutic footwear and inserts designed to reduce the risk of foot ulcers in people with diabetes.

People with diabetes account for 67% of all lower-limb amputations in the US. Nearly half of these cases have been attributed to a chain of events that begins with ill-fitting footwear and ends with foot ulcers and amputations.

The research involved three groups of diabetic patients over a two year period. Each group was randomly assigned to wear either therapeutic shoes with customised cork inserts, therapeutic shoes with prefabricated polyurethane inserts, or their own normal shoes.

At the end of the two years, researchers compared how many in each group developed foot ulcers and found little difference in ulcer rates between the groups - 15%, 14%, and 17% in each group, respectively, developed ulcers. The results suggested that therapeutic footwear and inserts may not be any healthier than normal shoes.