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Diabetic Foot DiseaseNCT07905664

Better Care Closer to Home: Enhancing Primary and Community Care

A study testing Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease in people with Diabetic Foot Disease and Recurrence, run by Universidad Complutense de Madrid at 3 sites in 3 countries.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

60 million people in Europe have diabetes (DM) and up to 34% (20.4 million) of them are at risk of developing diabetic foot ulcers (DFUs) in their lifetime (1). However, current primary and community care is suboptimal with 40% of DFUs recurring within a year. Read more about this study

Who is it for?
Any age
Conditions the study is for
Diabetic Foot Disease, Recurrence
What is being tested?
Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
84 participants
Where
3 sitesin 3 countries
Study dates
1 Apr 2027to 20 Dec 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Adult patients of either sex aged 18 years or older.
  • Patients with the capacity to provide written informed consent and to comply rigorously with all study procedures.
  • Diagnosis of Type 1 or Type 2 Diabetes Mellitus.
  • Presence of diabetic peripheral neuropathy.
  • History of a plantar diabetic foot ulcer.
  • Patients able to walk at least 100 meters without the assistance of mobility aids and who own a smartphone compatible with the Path Active™ technology.

Who cannot join

  • Presence of an active diabetic foot ulcer at the time of study enrollment. Use of non-compressible orthopedic devices that prevent the use or fitting of the Path Active™ device.
  • Presence of severe peripheral arterial disease (PAD) confirmed by non-invasive vascular testing (11), defined as any of the following:
  • Ankle-Brachial Index (ABI) < 0.5 (or > 1.4 in the presence of non-compressible arteries).
  • Toe-Brachial Index (TBI) < 0.3, or Toe systolic pressure < 30 mmHg.
  • Lower-limb amputation that prevents minimal ambulation or requires the use of walking aids (partial toe amputations will be permitted).
  • Diagnosis of dementia or the presence of moderate-to-severe cognitive impairment.
Show all 9Show fewer
  • Vestibular or inner-ear disorders that impair balance and may increase the risk of falls.
  • Body weight > 130 kg, as this may affect the accuracy and performance of the device.
  • Any medical, psychological, or social condition that, in the opinion of the investigator, may interfere with study participation or place the participant at additional risk.

Trial locations and contacts

3 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

Mateo López-Moral, Professor, PhD contact

+34 652311573

matlopez@ucm.es

Francisco Javier Álvaro-Afonso, Professor, PhD contact

alvaro@ucm.es

3 sites in 3 countries

Canada1 site
  • University of Quebec in Trois-Rivieres

    Québec

    Magali Brousseau-Foley, PhD, magali.brousseau-foley@uqtr.ca

Other trials in Canada

Denmark1 site
  • Steno Diabetes Center

    Aalborg

    Nicklas H. Rassmussen

Other trials in Denmark

Spain1 site
  • Diabetic Foot Unit, Universidad Complutense Madrid

    Madrid, Madrid, 28040

    Mateo López-Moral, Professor, PhD, +34 652311573, matlopez@ucm.es

    Francisco Javier Álvaro-Afonso, Professor, PhD

Other trials in Spain

About this study

Official title: Smart Technology for Remote Intervention in Diabetic Foot ulcEr Prevention in COMmunity Settings

60 million people in Europe have diabetes (DM) and up to 34% (20.4 million) of them are at risk of developing diabetic foot ulcers (DFUs) in their lifetime (1). However, current primary and community care is suboptimal with 40% of DFUs recurring within a year. Path Active (PA) is a digital health tool composed of smart insoles and a Bluetooth-connected app, which remotely monitors users' DFU risk, reducing their reliance on institutionalised care.

This project will use interdisciplinary approaches to assess PA's ability to strengthen primary and community care systems (Subtopic 1) in culturally and socioeconomically diverse settings. We will take an ecosystem approach, incorporating multiple stakeholders including end-user patients,healthcare professionals, policy makers and potential commercial partners, investigating PA through economic, social, and clinical lenses. The project will pilot PA in >100 individuals across 3 different countries (Canada, Denmark, and Spain) over 18 months. This will allow us to carry out:

Read more
  • Implementation research: Mapping PA implementation in diverse care settings, identifying local barriers to PA's adoption and necessary changes to promote PA integration into community care.
  • Service and ICT research: End user-testing to facilitate iterative design improvements, ensuring PA is culturally appropriate.
  • Health economics and policy research: Investigate international policy impact on the health economics surrounding PA and inform PA's market plan for different health systems.
  • Pilots: Gather evidence on PA's effectiveness in preventing DFUs and investigate/tackle any potential efficacy differences between cultures.
  • Business development: Scale up PA production and map potential stakeholders in member sites.

Overall, STRIDE-COM represents a significant step toward integrating innovative digital health solutions into primary care across Europe/Canada, establishing a replicable model for wearable technologies.

Read the detailed description

Background: There are 60 million people in Europe with DM (WHO) and up to 34% (20.4 million) of these patients develop DFUs in their lifetime. DFUs take significant time to heal, 12% never heal and result in amputations within 5 years. In Europe, total treatment cost per patient for DFU in 2005 was €10,091, with amputation (€889) and hospitalisation (€3892) approximating 50% of the total direct cost (3). Since the incidence of DFUs is approximately 2% annually in the diabetic population in Europe, the annual costs would be approximately €12B (€10,091*0.02*60,000,000).

State-of-the-art/unmet need: DFU management is suboptimal with 40% of DFUs reoccurring within 1 year, affecting quality of life (QoL). Current care is based around frequent clinic visits (up to weekly) for foot checks. This overreliance on institutionalised care is inconvenient and often impractical for those in rural areas without access to nearby specialised care and thus have a higher DFU risk than urban counterparts.

Technical challenge addressed: STRIDE-COM addresses the need for enhanced primary and community care of DFUs by providing remote monitoring via Path Active (PA). PA is a digital health tool composed of smart temperature- and pressure-sensing insoles and a Bluetooth-connected app, which monitors users' DFU risk, alerting them and their healthcare professionals (HCP) when they are at high risk. PA allows DFU care to be returned to the primary/community level, allowing users to come in only when necessary and empower them to take control of their own health, offloading their feet to reduce DFU risk. STRIDE-COM addresses the challenge of implementing PA across different language/cultural/regulatory contexts. It does so by piloting PA in three different countries and taking into account the economic, socioeconomic, cultural, geographical, and policy differences between various regions which could impact the rollout of such smart wearable solutions.

Scope Transformative innovation - Strengthening primary and community care: STRIDE-COM will transform both primary and community care for individuals at risk of DFUs. PA's remote monitoring will shift the current clinical pathway for foot monitoring from specialist care to community/primary care levels.

Overall, this will reduce burdens on the entire healthcare system by reducing frequent podiatry clinic visits and preventing DFUs, which are a major healthcare burden. PA provides a simple, intuitive, user-friendly tool to reduce the fragmentation of DFU care in different EU countries and beyond and provide more equitable and integrated care regardless of geographical location.

Being tested
Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease
Keywords
Diabetes, Healthtech, Ulcers, Remote, Smart, Monitoring, Ulcer prevention, Biomechanics
Medical subject headings
Recurrence, Diabetes Mellitus, Ulcer

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot diseaseDevice

    The investigational intervention is Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease by monitoring plantar temperature and plantar pressure patterns, and transmitting these data to a mobile application.

    Participants in both study arms will receive the Path Active™ insoles and the corresponding mobile application. The only difference between the study groups is whether the ulcer-risk alert functionality is enabled or disabled. In the intervention group, the system will generate alerts based on the assessed risk of developing plantar diabetic foot ulcers, whereas in the control group all ulcer-risk alerts will be disabled. All other device functionalities, including plantar pressure and temperature monitoring, will remain active in both groups.

Study groups in NCT07905664
Study groupRoleWhat they receive
Intervention: Path Active™ with ulcer-risk alerts enabledExperimentalProviding notifications based on the risk of developing plantar diabetic foot ulcers.
Receives: Device: Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease
Control: Path Active™ with all ulcer-risk alerts completely disabledActive comparatorUlcer-risk alerts completely disabled. However, all other device functionalities will remain active, including pressure and temperature monitoring.
Receives: Device: Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of recurrent events

    The number of new diabetic foot ulcer events for each participant will be recorded monthly during the study period by respective clinical sites using electronic medical records

    Measured: 12 months

  2. Quality of Life

    Participant responses at each time point will be scored using standard EuroQol 5-Dimension 5-Level (EQ-5D-5L) algorithms.

    Measured: 12 months

  3. Ulcer Location

    Ulcer site (plantar vs. non-plantar) will be recorded by podiatrists at our respective clinical sites in the case of ulcer occurrence

    Measured: 12 months

  4. Adherence

    Derived from both self-reported data (collected at Months 9 and 18) and PA sensor data (hours worn/day). Compliance will be defined using the threshold of ≥4.5 hours/day

    Measured: 12 months

  5. Foot-Care Behaviour

    (Diabetic Foot Self-Care Questionnaire - DFSQ-UMA): Questionnaire scores will be calculated according to the validated scoring system

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Oct 2026
  2. Study start1 Apr 2027 (estimated)
  3. Primary completion20 Dec 2029 (estimated)
  4. Study completion20 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
A multicenter, randomized, double-blind, parallel-group clinical trial is proposed to evaluate the effectiveness of the Path Active™ Smart Insole System technology in the prevention of diabetic plantar foot ulcers (DFUs) in individuals at high risk of developing a DFU (history of previous ulceration). Participants will be randomly assigned in a 1:1 ratio to one of two parallel study groups: Group 1 - Intervention: Path Active™ with alerts enabled based on the risk of developing plantar diabetic foot ulcers. Group 2 - Control: Path Active™ with all ulcer risk alerts completely disabled. However, all other functions will remain active (pressure and temperature monitoring). The study will be conducted across different countries and healthcare settings (Spain, Denmark, and Canada). In Spain, two previously identified independent participating centers will be involved. Each center will have a Principal Investigator responsible for participant enrollment a
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
84 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07905664
Sponsor's protocol ID
THCS-Consortium RCT
Other IDs
THCS Grant 101095654
Status last verified
Oct 2026
First submitted
23 Oct 2026
Last updated
3 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Lavery LA, Petersen BJ, Linders DR, Bloom JD, Rothenberg GM, Armstrong DG. Unilateral remote temperature monitoring to predict future ulceration for the diabetic foot in remission. BMJ Open Diabetes Res Care. 2019 Aug 6;7(1):e000696. doi: 10.1136/bmjdrc-2019-000696. eCollection 2019.

    PubMed 31423317

Questions about this trial

What is this clinical trial studying?

A study testing Path Active™, a smart insole system designed to reduce the risk of plantar ulceration in patients with diabetic foot disease in people with Diabetic Foot Disease and Recurrence, run by Universidad Complutense de Madrid at 3 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Canada, Denmark, Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mateo López-Moral, Professor, PhD (+34 652311573, matlopez@ucm.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of recurrent events (time frame: 12 months). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07905664, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.

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