These Smart Socks Keep Tabs on People With Diabetes (2024)

We've been hearing about "smart fabrics" that respond to the human wearer for years but little has transpired, apart from floaty dresses that light up with LEDs, or mod-style parkas threaded with charging cords. But something that saves your life? That's worth a look.

PCMag was in San Francisco recently and sat down with Ran Ma, CEO and Founder of Siren, the company behind Neurofabric, a microsensor-embedded textile featured in its Diabetic Socks and Foot Monitoring System. It won a CES 2018 Innovation Award and has seed funding of $3.4 million from DCM, Khosla Ventures, and Founders Fund.

Ma was born in China, and moved to Dallas with her parents, who are both doctors, when she was five. After studying Biomedical Engineering at Johns Hopkins, Ma worked in Sweden and Denmark, before returning to the states in 2015 to start Siren. Here are edited and condensed excerpts from our conversation.

Tell us how you came up with the idea for Neurofabric.
When I was studying biomedical engineering, we were trained to look at the problem first, before developing a tech solution, not the other way round. So when I heard there are 100,000 foot and leg amputations each year due to diabetic foot ulcers, I decided to create "smart socks" that monitor foot temperature to detect inflammation.

How did you make the socks "smart"?
There's a small battery at the top of each sock. Then six sensors in each sock, so 12 in a pair, which communicate with our Siren MCU—microcontroller unit [or] hub—and the phone app, via Bluetooth. The socks' system continuously tracks the temperature in each foot then, if there is a 4-degree Fahrenheit difference between one spot and the same spot on the other foot, over a 24- to 48-hour period, you'll see a red spot show up on the app.

An alarm goes off when the temperature gets into the danger zone?
Yes, if you don't respond to the app or hub notification, we call or text you to say "reduce activity, check your feet, and if the problem continues, you need to see your doctor immediately."

True remote telemedicine.
A lot of people living with diabetes lose the ability to feel pain so don't notice injury. Then [they] get infected and ultimately they can lose their leg through amputation. Eighty percent of people pass away within five years after a lower leg amputation.

Scary. Have you got data to prove Neurofabric saves limbs?
Yes. Temperature monitoring has been proven over decades of clinical studies to be up to 87 percent more effective at preventing ulcers than the usual standard foot care methods. The Siren system makes this monitoring continual, so you can collect temperature measurements at every moment throughout the day.

Did you 3D print all the parts?
We use off-the-shelf parts for the sensors and thermistors, then we have a "secret sauce" to embed them inside the fabric.

Is that one of the patents you've registered?
Yes, we've filed five patents so far, including one for "standard manufacturing of integrated sensors" using standard weaving machines, and "simultaneous pairing of multiple devices," both of which were previously unsolved. As you can see, there's no hand embroidery on the sock. In the future we want to migrate more and more of these parts into the fabric itself.

How long does the battery last?
A year. But people with diabetes need to get new socks every six months, so that's our business model. For a flat subscription fee of $19.95 per month, you get five pairs of socks, every six months, together with the hub, app, online portal, and customer support.

Do you need a special bio-powder to clean them?
No. Our socks are machine washable and machine dryable.

Even with all the embedded tech?
Exactly. That's the magic of our biomedical engineering.

Is Neurofabric going to launch a new industry sector, not wearables, but something similar?
People say wearables are "so 2014," but I think the problem is people were expected to adopt a new form factor. It's not that there's no place in our lives for wearables, is that we haven't found the right place. At Siren, we think wearables make most sense in wellness and health care, particularly for chronic diseases that people need to have information about on a consistent basis. They also need to be invisible and seamless, fitting into objects you already use.

You don't envisage us walking around in Tron gear then.
My spandex neon Tron days are over, apart from maybe at the odd festival [Laughs]. Seriously though, I want to re-engineer everyday objects and put intelligence inside. I don't want to create technology for technology's sake. With my medical background I am dedicated to addressing chronic diseases and aging. None of us are getting any younger.

The (final) exit is out there.
I want to make sure that we have technology that is graceful, dignified, and can solve real problems.

On a lighter note, talk us through your design choices.
I have been inspired by Nordic design, which is fit for purpose. Clean, simple, elegant colors to help people gain independence. We don't want people to feel like it's a chore to wear a product.

Do the socks just come in white?
Traditionally, diabetic socks are white so people with diabetes can see the blood from injuries and get help - many can't feel their feet.

But Neurofabric can come in other colors, when you develop different use cases?
Absolutely. And with our alternative injury identification methods, we will be releasing socks in a variety of colors. The socks already come in black, blue, gray, and white.

Your logo is a mermaid, which is very Danish.
I was inspired by the story of The Little Mermaid where she has extreme pain when she gets her feet in the end. But pain is a good thing, because it's what protects us from injury. It's the national symbol of Denmark and also a "siren" is an alert.

What do you bring to your product from your Chinese background?
In Chinese culture we are focused on prevention. I come from generations of doctors, my grandparents are doctors, as are my parents, aunts, and uncles. My parents both work in late-stage cancer, and my father is a surgeon where he deals with many late-stage problems that people have to deal with. I have dedicated my life to helping patients. But I wanted to go "upstream," making sure people get the right tools at the right time.

Now you've got the smart socks out in the market, what's next for Neurofabric?
We have a lot of ideas in the pipeline, but we're not ready to talk about it yet. There are other sensor modalities we might use, such as steps, pressure, moisture, alongside temperature, but that's the one with the most clinical reasoning behind it right now. On another note, do you know the sci-fi novel Rainbows End?

By Vernor Vinge? Yes.
In it everyone is wearing smart clothes, smart contact lenses, and has the ability to access communication and see a mixed reality before them. One of our investors said "You're building the world we first saw in Rainbows End!"

And in a nice twist, the full title of that book is Rainbows End: A Novel With One Foot in the Future. Perfect for a biomedical engineering tech startup that started with smart socks.
Indeed [Laughs].

Ran Ma will be speaking at the AADE18 conference in Baltimore (August 17-20).