Two different types of footwear will be evaluated for feasibility and acceptability in this trial: optimally designed therapeutic footwear (Fig. (Fig.1)1) and usual care (patients’ own footwear for control group).

Therapeutic footwear with merino wool, vibration chip, and orthopedic insoles will be optimally designed by the Beijing Ounce Health Technology Limited Company. The size of footwear will be defined based on patients’ foot size. Merino wool from New Zealand will be used for the manufacture of comfortable shoe vamp and lining. A Vibration chip is included in a Bloodstream Improvement Device (BID) which is designed to change external impact energy into vibration energy and placed at the back of the heel of therapeutic footwear. BID is a magnetic field generated by repulsive force that does not require any electric devices and can operate semi-permanently. The vibration of BID is natural penetration vibration penetrating deeply into the human body, which is a nature-friendly vibration different from other battery vibration. Orthopedic insoles will be designed and optimized using the footscan® system (RSscan international NV, Paal, Blegium). The insole will be constructed from merino wool and high-density polyurethane foam materials. Characteristics of orthopedic insoles and shoe soles were showed in Table 1.

Characteristics of orthopedic insoles and shoe soles of novel diabetic therapeutic footwear

The control group will receive patients’ own footwear. Control footwear will be constructed from materials commonly used in the manufacture of athletic shoes.