Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM.

Background The aim of this bibliometric study was to examine trends in the quality and quantity of published diabetes-related foot disease (DRFD) research in Aotearoa/New Zealand (NZ) over the past five decades. Method In July 2021, the Scopus® database was searched for DRFD-related publications (1970–2020) using predetermined search and inclusion criteria. Bibliometric data were extracted from Scopus® and Journal Citation Reports. Retrieved bibliometric indicators were analysed in Biblioshiny, an R Statistical Software interface and reported using descriptive statistics. Results Forty-seven DRFD-related articles were identified. The annual number of publications showed a significant upward trend increasing from one in 1988 to a peak of six in 2018 (P < 0.001). The majority of identified articles (n = 31, 66%) were published in the last decade (2011–2020). Basic/clinical research accounted for 87% (n = 41) of publications and 14 (30%) investigated the screening and/or prevention of DRFD. The average citation per article was 20.23 (range: 0–209) and the median impact factor was 4.31 (range, 1.82–79.32). Over a third of articles (36%) had an international authorship network. Funding was reported in 15 (32%) articles; 12 (26%) were supported by public national grants vs. three (6%) reporting industry-sponsorship. Conclusion DRFD articles authored by NZ researchers have increased over the past five decades. Despite NZ researchers having increased their global impact through collaborative networks, most of the research was classified as low-level evidence, with limited focus on Indigenous Māori and limited financial support and funding. Increased funding for interventional research is required to enable a higher level of evidence-based and practice-changing research to occur. With rates of diabetes-related amputations higher in Māori future research must focus on reducing inequalities in diabetes-related outcomes for Māori by specifically targeting the prevention and screening of DRFD in primary care settings in NZ.

Padded socks to protect the at-risk diabetic foot have been available for a number of years. However, the evidence base to support their use is not well known. We aimed to undertake a systematic review of padded socks for people with diabetes. Additionally, a narrative analysis of knitted stitch structures, yarn and fibres used together with the proposed benefits fibre properties may add to the sock. Assessment of the methodological quality was undertaken using a quality tool to assess non-randomised trials. From the 81 articles identified only seven met the inclusion criteria. The evidence to support to use of padded socks is limited. There is a suggestion these simple-to-use interventions could be of value, particularly in terms of plantar pressure reduction. However, the range of methods used and limited methodological quality limits direct comparison between studies. The socks were generally of a sophisticated design with complex use of knit patterns and yarn content. This systematic review provides limited support for the use of padded socks in the diabetic population to protect vulnerable feet. More high quality studies are needed; including qualitative components of sock wear and sock design, prospective randomized controlled trials and analysis of the cost-effectiveness of protective socks as a non-surgical intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-015-0068-7) contains supplementary material, which is available to authorized users.

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