AI-powered smart insoles are emerging as a promising tool for diabetic foot monitoring, offering a potential way to detect early warning signs before ulcers, infections and amputations occur.
A recent article by Diabetes in Control highlights how smart insole systems can combine sensors, artificial intelligence, pressure monitoring, temperature tracking and mobile alerts to support people living with diabetes. For India, where diabetes-related foot complications remain a major cause of preventable lower-limb amputation, this technology could become an important part of future diabetic foot care.
Diabetic foot ulcers often develop when neuropathy reduces protective sensation and high-pressure areas go unnoticed. A patient may continue walking on a pressure point, callus, blister or minor wound because they do not feel pain. Over time, this can lead to ulceration, infection, hospitalisation and, in severe cases, amputation. Smart insoles aim to change this pathway by identifying risk earlier.
The basic concept is simple but powerful. Sensors embedded inside the insole monitor the foot during daily activity. Depending on the system, these sensors may track plantar pressure, temperature, activity, gait and adherence. Data can then be analysed by software or AI algorithms to detect high-risk patterns. If a pressure hotspot, abnormal temperature increase or concerning activity pattern is detected, the user or clinician can be alerted.
This matters because the diabetic foot is often a silent problem until it becomes severe. By the time an ulcer is visible, the patient may already require wound care, offloading, antibiotics, surgical review or hospital admission. Continuous or regular monitoring may allow clinicians to intervene earlier with footwear changes, custom insoles, offloading, wound checks, patient education or activity modification.
A 2024 review in Sensors noted that several studies have proposed smart insoles for monitoring dynamic plantar forces in people with diabetes, with the goal of helping prevent diabetic foot complications. The review highlights the role of pressure and temperature monitoring, wearable electronics and data analysis in future diabetic foot prevention strategies. (PMC review on diabetic foot insoles)
Clinical evidence is also developing. A study published in The Lancet Digital Health found that an intelligent insole system with pressure feedback reduced episodes of high plantar pressure in people at high risk of diabetic foot ulcers. The system continuously monitored plantar pressure and provided feedback, helping users recognise and avoid activities that created high-risk pressure patterns. (The Lancet Digital Health study)
For orthotists, prosthetists, podiatrists, diabetologists and rehabilitation teams, the technology is relevant because it connects monitoring with intervention. A smart insole is most useful when it leads to action: modifying footwear, adjusting an orthosis, changing walking behaviour, offloading a wound, reviewing skin condition or referring the patient for specialist care.
India’s need for such tools is clear. The country has one of the world’s largest populations of people living with diabetes, and many patients face delayed diagnosis, limited foot screening and inconsistent access to specialist diabetic foot services. The International Diabetes Federation estimates that diabetes affects hundreds of millions of adults globally, with South Asia carrying a major share of the burden. For India, diabetic foot prevention must become a mainstream public health and rehabilitation priority.
Smart insoles could support diabetic foot care in several ways:
- Detecting high plantar pressure during daily activity
- Identifying temperature changes that may suggest inflammation or tissue stress
- Supporting remote monitoring between clinic visits
- Encouraging patients to reduce pressure or modify activity
- Helping clinicians assess footwear and orthotic effectiveness
- Improving adherence data for prescribed footwear or insoles
- Creating digital records for long-term risk management
For BharatCPO readers, the technology also reinforces the value of orthotic intervention. Traditional diabetic foot care often relies on clinic-based assessment, visual inspection and patient self-checks. These remain essential, but smart insoles may provide additional information from the patient’s real environment: how they walk, how pressure changes through the day, and whether offloading advice is being followed.
This is especially important because clinic-based pressure assessment captures only a short snapshot. Daily life is different. A patient may walk longer than expected, use unsuitable footwear at home, stand for extended periods, or ignore early warning signs because there is no pain. Smart insoles can help bridge the gap between clinical prescription and real-world use.
However, smart insole technology should not be presented as a replacement for clinical care. It should support a wider diabetic foot pathway that includes regular screening, neuropathy assessment, vascular review, callus management, wound care, footwear prescription, custom insoles, patient education and rapid referral when risk is detected.
For India, the practical questions will include affordability, durability, battery life, data connectivity, language access, clinician training and integration with public and private care models. A smart insole that works well in a research setting may need adaptation for hot climates, dust, rural use, intermittent internet access and cost-sensitive patients.
The role of AI also needs careful governance. AI can help identify patterns in pressure, temperature and activity data, but alerts must be clinically meaningful. Too many false alarms may cause patients to ignore the system, while missed warnings could create false reassurance. Data privacy, secure storage and responsible use of patient information must also be part of implementation.
For Indian O&P clinics, smart insoles may open new opportunities. Clinicians could use pressure and activity data to refine custom foot orthoses, evaluate offloading footwear, monitor high-risk patients remotely and document outcomes. In the future, AI-supported systems may even help recommend personalised offloading strategies based on each patient’s foot shape, walking pattern, pressure profile and lifestyle.
Researchers have already explored AI-driven personalised offloading prescriptions for people at risk of diabetes-related plantar forefoot ulcers, including the use of machine learning and patient-specific data to support footwear and insole recommendations. (AI-driven offloading prescription research)
For India’s diabetic foot services, the most important opportunity is prevention. Every avoided ulcer can reduce pain, cost, hospitalisation, family burden and amputation risk. Every prevented amputation also reduces the later demand for prosthetic rehabilitation, long-term disability support and economic dependency.
The future of diabetic foot care in India is likely to combine several tools: education, regular screening, therapeutic footwear, custom insoles, pressure mapping, smart wearables, telehealth and rapid referral pathways. AI smart insoles could become one part of this ecosystem, especially for high-risk patients with neuropathy, previous ulceration, deformity or partial foot amputation.
For BharatCPO, the message is clear. Diabetic foot care must shift from late-stage wound treatment to early risk detection and prevention. Smart insoles may help make that shift possible, but only if they are clinically integrated, affordable and supported by trained professionals.
India’s orthotics and prosthetics community has a major role to play. CPOs can help translate sensor data into practical interventions: better insoles, safer footwear, improved offloading, patient education and timely follow-up. In that sense, AI is not replacing the clinician. It is giving the clinician more information to protect the foot before damage becomes irreversible.
- Original Diabetes in Control article on AI diabetic foot monitoring and smart insoles
- Review on advancements in diabetic foot insoles
- The Lancet Digital Health study on intelligent insoles and diabetic foot ulcer recurrence
- Orpyx Sensory Insole system
- International Diabetes Federation diabetes facts and figures
- WHO diabetes fact sheet
- AI-driven personalised offloading prescription research
- WHO standards for prosthetics and orthotics