Telepodiatry and smart insoles for remote monitoring of the diabetic foot

Diabetic foot ulcers are a frequent and recurrent complication of diabetes that precede most lower-extremity amputations, and access to specialized foot care remains uneven across regions. This narrative review synthesizes the evidence on two technologies for remote monitoring of the diabetic foot: telepodiatry and smart insoles. Randomized trials indicate that telemedicine for diabetic foot ulcer care shortens healing time and that telemedical plantar temperature monitoring is feasible in high-risk patients, building on older trials of home thermometry. Smart insoles detect offloading adherence and plantar pressure patterns, and continuous temperature-monitoring socks and insoles capture early inflammatory signals, although most devices remain at the prototype or pilot stage. Adherence to remote monitoring is generally high but declines over time and depends on usability, feedback and workflow integration. The field converges on multimodal sensing that combines pressure, temperature and imaging with remote supervision, but clinical endpoint trials, standardized validation and equity-oriented implementation are still scarce. These technologies can extend specialist podiatric care beyond the clinic, yet their clinical benefit for ulcer prevention and recurrence still requires confirmation in pragmatic trials.