CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-14). The draft was written by AI, the existence of all 1 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2586 · Search date 2026-08-14 · Methodology v0.7

Smart pressure-sensing insoles,
does it really help with Reduced recurrence of healed plantar diabetic foot ulcers?

30-Second Summary
C
Evidence Grade C · 54 · Safety caution
Alerted participants had fewer ulcer events, but the small trial had major attrition
Offloading actions should be adjusted with gait stability and skin status in mind. New wounds, redness, or warmth require diabetic-foot assessment rather than reliance on device alerts alone.
What the
research shows
The grade is C with 54 points. In an 18-month proof-of-concept randomized trial, the alert group had four ulcers over 11,835 person-days versus ten over 8,638 person-days without alerts, incidence rate ratio 0.29 (95% CI 0.09-0.93). However, only 58 of 90 randomized participants entered the main analysis, and the proportion of people with at least one ulcer, 4/32 versus 6/26, was not significantly different.
What the
ads claim
A sensor recording pressure and issuing alerts is a device fact; fewer clinical ulcers is a separate efficacy claim. The comparator used the same insole without alerts, not no device.
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Useful facts when choosing a product

  • Each insole had eight pressure sensors sampling at 8 Hz.
  • Accumulated pressure at or above 35 mmHg triggered audiovisual and vibration alerts with offloading instructions.
  • Alert operation and ulcer prevention are different claims; two independent masked experts verified ulcers from photographs.
Gap Measurement · Verdict 2586 · C 54
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Abbott and colleagues randomized 90 patients with recently healed plantar ulcers and peripheral neuropathy at two UK diabetic-foot clinics. Both groups wore SurroSense Rx; only the intervention group received audiovisual and vibration alerts plus offloading instructions when pressure above 35 mmHg accumulated. Monthly clinicians and two photograph reviewers were masked, while the Poisson analysis used follow-up accrued by the 58 participants who entered the study analysis.

02

Why this is classified as C (54)

Ulcer-event incidence fell, but major attrition from 90 randomized to 58 analyzed and a sample below 200 impose a C ceiling, giving 54 points.

Counterpoint. This verdict applies to high-risk patients with a recently healed plantar ulcer and neuropathy, not general gait-analysis insoles or primary ulcer prevention.

Rejudgment record. Cross-check applied — Cross-checked the primary endpoint, 90 randomized versus 58 analyzed, incidence-rate and patient-level results, funding, and masking against the article and registry

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI1Mixed funding sources
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Smartwatch alerts reduce recurrent plantar-ulcer event incidenceCThe incidence rate ratio was 0.29, but only 58 of 90 randomized participants were analyzed.
Smartwatch alerts reduce the number of patients with any recurrenceDThe difference, 4/32 versus 6/26, was not significant, P=0.29.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Two-clinic single-masked randomized proof-of-concept trial26Diabetes UK funded the first three years; Orpyx Medical Technologies funded the final year, a researcher salary, and technical supportPlantar-ulcer recurrence over 18 months, counted as events and affected patientsFour events/11,835 person-days versus ten/8,638, IRR 0.29 (95% CI 0.09-0.93); affected patients 4/32 versus 6/26, P=0.29Only direct clinical trial
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Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-14).

Abbott CA, Chatwin KE, Foden P, Hasan AN, Sange C, Rajbhandari SM, Reddy PN, Vileikyte L, Bowling FL, Boulton AJM, Reeves ND. Innovative intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective, randomised, proof-of-concept study. Lancet Digit Health. 2019;1(6):e308-e318. PMID: 33323253. DOI: 10.1016/S2589-7500(19)30128-1. ISRCTN05585501.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none

Cite this verdict

Smart pressure-sensing insoles x recurrent plantar diabetic foot ulcers Evidence Grade C card
[Chamgap] Smart pressure-sensing insoles x recurrent plantar diabetic foot ulcers — Evidence Grade C·54. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/blood-sugar/smart-pressure-insole-diabetic-foot-ulcer-recurrence/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

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