Machine Learning for Diabetic Foot Care: Accuracy Trends and Emerging Directions in Healthcare AI

Pei-Chun Lin^1,2Tsai-Chung Li^1,3Tzu-Hsuan Huang⁴Ying-Lin Hsu⁴Wen-Chao Ho¹Ching-Liang Hsieh^5,6,7*Jia-Lang Xu^8*

• ¹Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
• ²Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
• ³Department of Audiology and Speech Language Pathology, College of Medical and Health Science, Asia University, Wufeng, Taichung County, Taiwan
• ⁴National Chung Hsing University, Taichung, Taiwan
• ⁵Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
• ⁶Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
• ⁷Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
• ⁸Chaoyang University of Technology, Taichung, Taiwan

Background: Diabetic foot is a common and debilitating complication of diabetes that significantly impacts patients' quality of life and frequently leads to amputation. In parallel, artificial intelligence (AI), particularly machine learning (ML), has emerged as a powerful tool in healthcare, offering novel solutions for disease prediction, monitoring, and management. Despite growing interest, a systematic overview of machine learning applications in diabetic foot research is still lacking. Objective: This study aims to systematically analyze recent literature to identify key trends, focus areas, and methodological approaches in the application of machine learning to diabetic foot research. Data Sources: A comprehensive literature search was conducted across three major databases: Web of Science (WoS), IEEE Xplore, and PubMed. The search targeted peerreviewed journal articles published between 2020 and 2024 that focused on the intersection of machine learning and diabetic foot management. Eligibility Criteria and Study Selection: Articles were included if they were indexed in the Science Citation Index (SCI) or Social Sciences Citation Index (SSCI), published in English. They explored the use of machine learning in diabetic foot-related applications. After removing duplicates and irrelevant entries, 25 original research articles were included for review.Results: There has been a steady increase in publications related to machine learning in diabetic foot research over the past five years. Among the 25 studies included, image analysis was the most prevalent theme (12 articles), dominated by thermal imaging applications (10 articles). General clinical imaging was less common (2 articles). Seven studies focused on structured clinical data analysis, while six explored IoT-based approaches such as smart insoles with integrated sensors for real-time foot monitoring.Citation analysis showed that Computers in Biology and Medicine and Sensors had the highest average citation rates among journals publishing multiple relevant studies.The integration of machine learning into diabetic foot research is rapidly evolving; it is characterized by growing diversity in data modalities and analytical techniques. Thermal imaging remains a key area of interest, while IoT innovations show promise for clinical translation. Future studies should aim to incorporate deep learning, genomic data, and large language models to further enhance the scope and clinical utility of diabetic foot research.