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Therapeutic Shoes for Persons with Diabetes

Last Modified: 10/05/2013

The Importace of Proper Footwear for Individuals with Diabetes
 
Proper fitting footwear is important to most of us as we like to be comfortable in our shoes.  However for those with diatetes, its more than just comfort, its a matter of life and limb. Wearing the wrong shoe or the wrong size can potentially cause serious health problems that can sometimes result in amputations. With approximately 20 million Americans diagnosed with diabetes, the need for proper fitting footwear is essential in maintaining a healthy lifestyle. Improper fitting shoes can cause nerve damage and poor circulation, facilitated by the diabetes. Moreover,  according to the American Podiatric Medical Association, poorly fit shoes are involved in as many as half of the problems that lead to amputations, making it the most common cause of non-traumatic lower limb amputations.  In fact, current statistics show that approximately 30% of diabetics that lose one limb from amputation will lose the other limb within three years. More disturbing is that approximately 60% of people with diabetes will die within five years of their first lower limb amputation.
 
The first step to the healthy diabetic feet is proper caring, cleaning and examination of the feet. This starts with regular visits to the primary care doctor. It is critical that persons with diabetes and peripheral neuropathy follow the advice of their doctor relating to proper foot care and maintenance.  About 65% of individuals with diabetes have a mild to severe form of nerve damage (called peripheral neuropathy) that can deprive them of their protective sensation in their feet. Diabetics suffering with peripheral neuropathy means that diabetics lacks the very sensation required to feel the fit of the shoe, and may be unable to trust their "senses" as to whether the shoe fits well or not. It is not unusual that people with peripheral neuropathy sometimes insist on wearing a shoe size that is too small because without proper sensation, the correct size seems to be too big.  The smaller size shoe can sometimes cause blisters or abrasion that can result in a diabetic ulcer, which can eventually lead to an amputation if untreated. 
 
Footwear should be examined and checked by the individual and family members as well as a Therapeutic shoe fitter or Pedorthist to ensure there is enough room in the shoe and that there are no pressure points obstructing a good fit.    Getting expert help to ensure proper fitting shoes might seem overboard to most of us, but it is one of the best preventative and proactive measures diabetics can take to stay on the healthy path.
 
People with diabetes usually require foot orthoses to balance and protect the foot and to unload and alleviate diabetic foot problems. The diabetic foot is the hardest foot to manage because it has all of the biomechanical challenges that non-diabetic feet have, coupled with the soft tissue challenges related to diabetes. Certified Pedorthists are specifically trained to manage diabetic feet and to help in the healing of current ulcers and the prevention of future ulcers
     
Most diabetic feet can be managed with off-the-shelf shoes and diabetic inserts. However, in some cases, including moderate to severe Charcot foot conditions, a custom molded shoe is the best treatment for the person with diabetesGood diabetic shoes are the base of support, cushion and comfort for the diabetic feet.  If the shoes don't fit well, then the custom or diabetic orthotics will not function properly and may cause potential problems. It is advisable that diabetics ask their physician, podiatrist or pedorthist to explain the construction and performance expectations of your shoes, inserts, or foot orthotics.  It is also extremely important that diabetics check and examine their feet and the fit of the shoes and inserts on a regular basis.
 
At Foot Companion, our Certified Pedorthist is trained in shoe fitting and diabetic foot management, and can expertly select and fit the proper shoe for a person with diabetes.   If you are a diabetic or know someone who is diabetic and needs good fitting shoes, please visit our shop or call us to set up an appointment.  Even if you cannot make it to our shop, we can set up an appointment to come to you, or we will try our best to answer your questions by phone at 1-855-324-3668 or email at info@footcompanion.com.
 
Please also browse through our Diabetic approved shoes by following the links below:
 
Tips on Caring For the Diabetic Feet
 
• Always follow your doctor’s instructions for proper foot care and maintenance.
• Revisit the practitioner who dispensed your shoes one to two weeks after getting new shoes, to address any issues and to recheck for proper fit.
• Inspect your feet for trouble signs everyday.  Look for any irregularities, redness or unusual swelling.  Contact your physician with any concerns.
• Dry your feet carefully with a soft towel, especially between the toes, as moisture can be trapped in these sensitive areas.
• Dust your feet with talcum powder or cornstarch to keep them dry..
• Check your shoes, socks, and orthotics daily for fit and defects and objects as foreign objects that can cause sores.
• Wear socks that are designed for the diabetic foot. These socks are softer, are seamless and without elastic.
• Always wear your shoes with socks.  This may seem obvious, but its worth mentioning.
• Never go barefoot outside – Always wear some sort of supportive footwear at all times to avoid cuts or other potential foot injuries, particularly if you have loss of sensation.
• Shop for shoes in the afternoon, as your feet are likely to be at their largest at this time of day.
• Visit your doctor on a regular basis for all of your foot care needs, especially to get your toenails clipped. 
 
 
Therapeutic Shoes For Diabetics - Meidcare Shoe Bill
 
In May 1993 Congress amended the Medicare statutes to provide partial reimbursement for depth shoes, custom-molded shoes, and shoe inserts or modifications to qualifying Medicare Part B patients with diabetes.
     
To qualify, the medical doctor (MD or DO) who manages the patient’s systemic diabetic condition, (i.e. prescribes insulin) must certify in a Statement of Certifying Physician that the patient has diabetes, that the patient is being treated under a comprehensive plan of care for diabetes, and that the patient has one or more of the conditions that Medicare describes as placing the patient at risk for amputation and that the patient therefore needs therapeutic footwear. 
 
With the two required documents, the above-mentioned Statement of Certifying Physician and a Footwear Prescription, Medicare will partially reimburse the beneficiary for the footwear, footwear modifications and foot orthoses needed to protect their feet. More information regarding the program can be obtained from Medicare at 800-270-2313 or www.cms.gov.
 
 
Additional Sources of Information
 
• American Diabetes Association: (1-800-342-2383)
• American Physical Therapy Association: (1-800-999-2782)
• Pedorthic Footwear Association: (1-800-673-8447)
 
 
Disclaimer: The information provided by Foot Companion, Inc. should never take the place of advice and guidance from your doctor. Be sure to check with your doctor about changes in your treatment plan. If you don’t have a doctor, we would be happy to provide you with a list of several health care providers in your area.  
 

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