# Diabetic Socks: A Systematic Review of the Literature and Commercially Available Products

## TL;DR

This review examines the limited evidence on diabetic socks, finding poor quality clinical trials and a lack of clinical support for commercial claims.

## Contribution

The paper systematically reviews both clinical and commercial evidence on diabetic socks, highlighting methodological gaps and design challenges.

## Key findings

- Clinical trials on diabetic socks show poor methodological quality and no significant outcomes.
- Laboratory studies suggest fiber blends and yarn finishes affect sock performance, but lack clinical validation.
- Commercial socks with new fibers often lack evidence to support their effectiveness for diabetes patients.

## Abstract

In recent years, various diabetic socks have been developed and introduced to help prevent diabetes related foot ulcers (DFUs). However, the question of which type of sock is most suitable for individuals with diabetes has not been adequately addressed. This review systematically explores the current evidence regarding the performance and structural properties of diabetic socks, along with a narrative analysis of commercial socks.

Four databases, including Web of Science, PubMed/Medline, CINAHL (EBSCO), and Google Scholar, were examined, resulting in the selection of nine articles. Methodological quality of the clinical trials was assessed using the Downs and Black tool. Additionally, 17 commercially available socks were selected for analysis.

Among the selected articles, four were clinical trials, two mixed‐design studies, and three laboratory‐based investigations. The clinical studies exhibited poor quality and were unable to demonstrate significant outcomes. Laboratory‐based studies indicated that functional finishes on yarns could prevent microbial growth and that the blend of fibres and the structure of the socks significantly affect the overall performance. Commercially available socks reporting new types of fibres lack clinical evidence to support their claims, complicating the understanding of their performance in people with diabetes.

Current evidence regarding the structure and function of diabetic socks is limited, with clinical trials characterised by poor methodological quality. Technical suggestions for diabetic sock design are based on limited evidence from laboratory‐based studies, highlighting gaps in the literature. This review highlights the need for further investigation to establish the evidence base for diabetic socks in supporting diabetic foot care.