The NHS has approved the world’s first device to prevent diabetic foot ulcers, making it available on prescription.
In addition to improving the lives and health of millions of people with diabetes, the device could save the NHS a lot of money – £1 billion is the annual cost of amputation, and each foot ulcer costs, on average, £5,500.
How does the device work?
The device, known as Liqua-care Diabetic Flowgel Orthotics, is an anatomically designed liquid gel insert that balances body weight distribution and massages muscles on the sole of the foot. It also increases blood circulation.
The patient slides the thin device – which is available in six sizes – into their shoe. The liquid gel alters the distribution of weight – excessive pressure on the feet being one of the causes of foot damage – and improves blood circulation in the feet.
It is the first device ever approved by the NHS to combat foot ulcers.
Foot ulcers and diabetes
Foot ulcers are one of the most common diabetic complications, with one in four people with diabetes developing the condition. 300 new cases of diabetes-related foot ulcers are diagnosed every day. Moreover, foot ulcers are one of the leading causes of amputation: of the 120 amputations performed every week, 80 per cent will be caused by a foot ulcer.
Foot ulcers are caused by several factors. One of the most prominent is diabetic neuropathy. Over time, repeated exposure to high blood glucose levels (hyperglycemia) can damage the nerves in the feet, making them less sensitive. As a result, small wounds on the feet can go unnoticed, get infected, and potentially require amputation.
High blood glucose levels also inhibit the healing process. Because of this, small wounds won’t heal as quickly. This factor, combined with the loss of sensation in the feet, make people with diabetes far more likely to develop foot ulcers, although they can affect anyone.
People with diabetes are urged to check their feet regularly.
Foot ulcers, amputation, and the NHS
Foot ulcers are the leading cause of amputation in people with diabetes, which is one of the most widespread and costly complications of diabetes. More than 100 amputations are performed in the UK every week, with an annual cost of £1 billion.
It is hoped that the new device, which will be available on prescription, could lower these costs. The price of one of the devices is only a small fraction of the cost of an average foot ulcer. The money saved could be reinvested in better care for people with diabetes and other diseases.
The answer to diabetic foot ulcers?
Duncan Stang, National Diabetes Foot Coordinator for Scotland, and leader of the clinical team, said: “The results that Liqua-care generated in the clinical trials were quite exceptional. For the sample group, of which nearly half had previously ulcerated therefore carrying a 50 per cent likelihood of re-ulceration within 12 months, these results were extremely important.
“To then realise that none of the group had a reported instance of ulceration two years later is nothing short of remarkable[…]this is a massive step forward in diabetes foot care.
“To have this clinically proven treatment which can prevent ulcers arriving rather than just treating them when they have developed is what the NHS, clinicians and patients alike have been waiting to arrive for a great many years.”
David Watt, managing director of Liqua-care, said: “We have taken a great deal of time and care to prove the effectiveness of Liqua-care insole in order for them to be made available on prescription for people with diabetes.
“A single foot ulcer costs the NHS approximately £5,500 to treat and the cost of one pair of insoles is one third of one per cent of that cost.
“Diabetes related foot ulcers have a high human cost too and with only 50 per cent of sufferers who had an amputation surviving for more than two years post-surgery, we need to do all we can to reduce the main cause of those amputations.”

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