Protective socks for people with diabetes: a systematic review and narrative analysis

Simon Otter, Keith Rome, Belinda Ihaka, Andrew South, Mandy Smith, Gupta Amit, Frances Joseph, Peter Heslop

Research output: Contribution to journalArticlepeer-review


Padded socks to protect the at-risk diabetic foot have been available for a number of years. However, the evidencebase to support their use is not well known. We aimed to undertake a systematic review of padded socks for peoplewith diabetes. Additionally, a narrative analysis of knitted stitch structures, yarn and fibres used together with theproposed benefits fibre properties may add to the sock. Assessment of the methodological quality was undertakenusing a quality tool to assess non-randomised trials. From the 81 articles identified only seven met the inclusioncriteria. The evidence to support to use of padded socks is limited. There is a suggestion these simple-to-useinterventions could be of value, particularly in terms of plantar pressure reduction. However, the range of methodsused and limited methodological quality limits direct comparison between studies. The socks were generally of asophisticated design with complex use of knit patterns and yarn content. This systematic review provides limitedsupport for the use of padded socks in the diabetic population to protect vulnerable feet. More high qualitystudies are needed; including qualitative components of sock wear and sock design, prospective randomizedcontrolled trials and analysis of the cost-effectiveness of protective socks as a non-surgical intervention.
Original languageEnglish
JournalJournal of Foot and Ankle Research
Issue number9
Publication statusPublished - 27 Mar 2015

Bibliographical note

© 2015 Otter et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


  • Diabetes
  • Diabetic foot
  • Offloading
  • Footwear


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