[Quality control and quality assurance in therapeutic shoes for the diabetic foot]

More than 90% of diabetic patients with previous neuropathic foot ulcers will experience ulcer relapses within 48 months of follow-up. Custom-made cushioned footwear, according to observations in 217 patients at various centres, can prevent approximately 50% of ulcer relapses. However, the reports quoted lack some precision and clarity as to the etiology of the foot lesions taken into account, the time the footwear had been worn by the patients, the quality of the footwear, as well as the quality of simultaneous foot care, and the total observation period. Future long-term studies on the efficiency of footwear for diabetic patients are warranted, with better standardization. It is suggested that new technical equipment for computerized monitoring of in-shoe foot-pressures during gait should be used for quality control of the footwear of diabetic patients.