Why ulcers form on the toes, heel, and top of the foot in diabetes
Official title: Biomechanical factors for non-plantar ulcers in diabetic foot disease
Funded at VA Puget Sound Healthcare System · NIH-11310873 · Data updated 2026-11-12
This project will measure how tissues at common non-sole areas of the diabetic foot (toes, heel, and top) respond to pressure and movement to help people with diabetes avoid ulcers.
Quick facts
| Grant type | NIH-funded research |
|---|---|
| Study type | NIH-funded research |
| Funding institution | VA Puget Sound Healthcare System NIH-funded |
| Lab location | 1 site (Seattle, United States) |
| Project start | April 1, 2025 |
| Project end | March 31, 2027 |
| Funding year | 2026 |
| NIH project number | 5I21RX005148-02 |
| Project ID | NIH-11310873 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with diabetes—especially veterans or those with prior foot ulcers or high risk for foot wounds—are the most likely candidates to contribute tissue samples or take part in measurements.
✕Less likely to help
People without diabetes or those whose foot problems come from non-mechanical causes are unlikely to gain direct benefit from this specific biomechanics work.
What this research studies
From my perspective as a patient, researchers will test the mechanical properties of foot tissues at places other than the sole, like the toes, heel, and dorsum, to see how they handle compression, shear, and friction. They will use a mix of live measurements and lab work on tissue samples, possibly including donated cadaver tissue, to develop reliable testing methods. The team will compare how these non-plantar tissues differ from the sole tissues already studied to find why ulcers start at these sites. The goal is to build a foundation that can guide better prevention and treatment options for ulcer-prone areas.
Why it matters
Potential benefit: If successful, this work could lead to targeted ways to prevent and treat ulcers on the toes, heel, and top of the foot, lowering infection and amputation risk for people with diabetes.
How similar studies have gone: Past work has clarified how sole (plantar) tissue changes with diabetes and led to improved care, but applying these mechanical testing methods to non-plantar sites is relatively new.
Where this research is happening
-
VA Puget Sound Healthcare System
Seattle, United States Active
Researchers
- Principal investigator: Telfer, Scott — VA Puget Sound Healthcare System
- Study coordinator: Telfer, Scott
Related research
Other NIH-funded projects on the same topics.
-
Improving Diabetic Foot Ulcer Offloading with User-Friendly Cast Walker Design
A small pilot study to see how different removable cast walker designs affect daily use and healing of diabetic foot ulcers.
-
Home-based exercise to help Veterans recover after healed diabetic foot ulcers
A home-based exercise program for Veterans who recently healed from a diabetic foot ulcer to improve walking and daily function.
-
How Medicaid Coverage Changes Diabetic Foot Care in Safety-Net Patients
This project looks at how new Medicaid coverage in California affects foot care, ED visits, and outcomes for adults with diabetes in safety-net populations.
-
Multi-targeted approach to help heal diabetic foot ulcers using electric fields and nitric oxide
A study to test a combo treatment using electric field stimulation and nitric oxide to boost healing in diabetic foot ulcers.
-
Wound fluid test to predict healing in diabetic foot ulcers
This project looks for chemical signals in the fluid from diabetic foot ulcers that could tell adults with diabetes whether a wound will heal with standard care or need a different treatment.
-
MTX-001 for healing diabetic foot ulcers in people with diabetes
A first–in–class biologic therapy called MTX-001 is being tested to help heal diabetic foot ulcers and reduce infection risk in adults with diabetes.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.