Next Article in Journal
Young Adults with Chronic Conditions During the COVID-19 Pandemic: Comparison with Healthy Peers, Risk and Resilience Factors
Next Article in Special Issue
Applying Design Thinking for Co-Designed Health Solutions: A Case Study on Chronic Kidney Disease in Regional Australia
Previous Article in Journal
Assessing Transportation Barriers to Maternal Care for Black Women in Los Angeles County
Previous Article in Special Issue
Users’ Perspectives on Primary Care and Public Health Services in the State of Rio de Janeiro, Brazil: A Cross-Sectional Study with Implications for Healthcare Quality Assessment
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
IJERPH
Volume 22
Issue 9
10.3390/ijerph22091430
ijerph-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

Digital Health Technologies for Diabetic Foot Ulcers: A Systematic Review of Clinical Evidence, Access Inequities, and Public Health Integration

by
Tatiana Cristina Dias de Oliveira
1,
Alana Ferreira de Oliveira
1,
Laila de Castro Araújo
1,
Maria Pantoja Moreira de Sena
2,
Valéria de Castro Fagundes
3,
Phelipe Augusto Rabelo Paixão
1,
Stefani Gisele Bastos Dornas
1,
Clarisse Andrade Sales
4,
Ana Paula Simões Castro
4,
Patricia Alves de Mendonça Cavalcante
4 and
Luann Wendel Pereira de Sena
1,4,*
1
Graduate Program in Family Health, Federal University of the South and Southeast of Pará, Maraba 68507-590, Brazil
2
Postgraduate Program in Tropical Diseases, Federal University of Pará, Belem 66075-110, Brazil
3
Faculty of Medical Sciences of Pará, Para 38405-320, Brazil
4
Postgraduate Program in Biodiversity and Biotechnology, Federal University of the South and Southeast of Pará, Maraba 68507-590, Brazil
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2025, 22(9), 1430; https://doi.org/10.3390/ijerph22091430
Submission received: 22 July 2025 / Revised: 1 September 2025 / Accepted: 11 September 2025 / Published: 13 September 2025
(This article belongs to the Special Issue Access to Public Health Services and Challenges to Healthcare Management)
Browse Figure
Versions Notes

Abstract

Diabetic foot ulcers are among the most severe complications of diabetes mellitus, disproportionately affecting populations in low- and middle-income countries. Digital health technologies have emerged as promising tools for prevention, diagnosis, and management; however, their effectiveness, usability, and applicability within public health systems remain insufficiently defined. This systematic review aimed to critically synthesize the clinical effectiveness, perceived usability, and methodological quality of digital interventions for the care of individuals with diabetes-related foot ulcers. A comprehensive search was performed in PubMed, Scopus, Web of Science, Embase, and Google Scholar for studies published between 2012 and 2024. Eighteen studies met the inclusion criteria, encompassing mobile health applications, wearable sensor devices, artificial intelligence-based tools, and telehealth platforms. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Artificial intelligence-driven approaches demonstrated high diagnostic accuracy, with sensitivity and specificity above 90% for ulcer detection and classification. Mobile applications showed positive effects on self-efficacy, glycemic control, and adherence to preventive foot care, while usability scores were consistently high. Wearable sensor devices demonstrated potential for reducing ulcer recurrence, though supporting evidence remains limited. Across studies, recurrent methodological limitations included small sample sizes, absence of control groups, lack of economic evaluations, and barriers related to digital literacy and interoperability between systems. Most investigations were conducted in high-income countries, with limited consideration of public health contexts such as the Brazilian Unified Health System. In conclusion, digital health technologies show promise in improving the care of individuals with diabetes-related foot complications but face significant challenges regarding scalability, equity of access, and integration into public healthcare systems. Future research should prioritize context-adapted designs, robust clinical trials, and economic evaluations to inform health policies and support the rational adoption of these tools within universal health coverage frameworks. PROSPERO registration number: CRD420251023152.
Keywords: diabetic foot; health technology; mobile health applications; digital health diabetic foot; health technology; mobile health applications; digital health

Share and Cite

MDPI and ACS Style

Dias de Oliveira, T.C.; de Oliveira, A.F.; Araújo, L.d.C.; Moreira de Sena, M.P.; Fagundes, V.d.C.; Rabelo Paixão, P.A.; Bastos Dornas, S.G.; Sales, C.A.; Simões Castro, A.P.; de Mendonça Cavalcante, P.A.; et al. Digital Health Technologies for Diabetic Foot Ulcers: A Systematic Review of Clinical Evidence, Access Inequities, and Public Health Integration. Int. J. Environ. Res. Public Health 2025, 22, 1430. https://doi.org/10.3390/ijerph22091430

AMA Style

Dias de Oliveira TC, de Oliveira AF, Araújo LdC, Moreira de Sena MP, Fagundes VdC, Rabelo Paixão PA, Bastos Dornas SG, Sales CA, Simões Castro AP, de Mendonça Cavalcante PA, et al. Digital Health Technologies for Diabetic Foot Ulcers: A Systematic Review of Clinical Evidence, Access Inequities, and Public Health Integration. International Journal of Environmental Research and Public Health. 2025; 22(9):1430. https://doi.org/10.3390/ijerph22091430

Chicago/Turabian Style

Dias de Oliveira, Tatiana Cristina, Alana Ferreira de Oliveira, Laila de Castro Araújo, Maria Pantoja Moreira de Sena, Valéria de Castro Fagundes, Phelipe Augusto Rabelo Paixão, Stefani Gisele Bastos Dornas, Clarisse Andrade Sales, Ana Paula Simões Castro, Patricia Alves de Mendonça Cavalcante, and et al. 2025. "Digital Health Technologies for Diabetic Foot Ulcers: A Systematic Review of Clinical Evidence, Access Inequities, and Public Health Integration" International Journal of Environmental Research and Public Health 22, no. 9: 1430. https://doi.org/10.3390/ijerph22091430

APA Style

Dias de Oliveira, T. C., de Oliveira, A. F., Araújo, L. d. C., Moreira de Sena, M. P., Fagundes, V. d. C., Rabelo Paixão, P. A., Bastos Dornas, S. G., Sales, C. A., Simões Castro, A. P., de Mendonça Cavalcante, P. A., & Pereira de Sena, L. W. (2025). Digital Health Technologies for Diabetic Foot Ulcers: A Systematic Review of Clinical Evidence, Access Inequities, and Public Health Integration. International Journal of Environmental Research and Public Health, 22(9), 1430. https://doi.org/10.3390/ijerph22091430

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop