The Diabetic Foot

The Right Equipment

Keeping your feet in good condition means proper protection against the elements. The only time you should be going barefoot is in bed and in the shower. Make sure your shoes and socks are appropriate for your needs. An extra investment may be required, but in the long run the comfort and reduced risk of complications will be well worth the added expense

Shoes off The Rack

You have several options for shoes, ranging from regular, off the rack footwear to custom made prescription shoes. If you don’t have any diagnosed podiatric conditions, you can probably fulfill your footwear needs at a regular shoe store. However, there are some sensible shoe tips you should follow to keep your feet safe:

  • Stay grounded. High heels are not good for your feet and can cause blisters.
  • On your toes. Open toed shoes also present a hazard, as they leave a good portion of your foot exposed. Skip the sandals and stay safe.
  • Get fit. If at all possible, have a trained sales person check the fit of your shoes in the store.
  • Wiggle room. Properly fitting shoes should leave room for your toes to move freely, and be wide and long enough for a firm yet comfortable fit.
  • Breathing room. Leather or canvas uppers are your best bet for shoes that allow your feet to breathe, not sweat.

Shoes By Prescription

lf you have existing foot problems, you’ll probably need something a little more customized. Depth shoes are special therapeutic footwear that have extra room for the toes and for any orthotic inserts. If you have foot problems like hammertoes or bunions, depth shoes may be appropriate for you. Orthotics are prescription devices that are inserted into shoes to relieve pressure and provide extra cushion and support. To produce a custom fit, your podiatrist may take special casts of your feet. Some newer orthotics production technology uses a sensor mat that you walk on to provide a computer generated view of what portions of your feet bear the greatest load. Special software then designs the specifications for orthotics that are made to order. Your podiatrist or a specialist called an orthotist or pedorthist (a person trained in the design, fabrication, and fit of orthotic inserts) can help fit you for orthotics. Health insurance frequently covers the cost of prescription footwear or devices, so check with your carrier. Medicare covers 80 percent of the cost of depthinlay shoes, custommolded shoes, and shoe inserts for people with diabetes whose doctors certify that they meet clinical qualifications. Your podiatrist can tell you more about your coverage. Custom-molded shoes may be required for some people with diabetes related foot deformities such as cases of Charcot foot. Again, these customized shoes are obtained through a podiatrist or orthotist, who performs a special casting to fit the shoes properly.

Sock Sense

Even the best fitting shoes won’t do much good if you’re wearing threadbare or hole riddled socks. Lay a good foundation with thick, well cushioned socks that are seamless and wick moisture away from the foot. Cotton, cotton polyester, or acrylic blends are all good choices. There are also some newer treated fabrics and blends out on the market, like Teflon and antimicrobial fibers, designed to prevent blisters and infection. Since socks are a relatively small investment, it’s a good idea to tryout a variety until you find a type that suits you in style and comfort. Tight and restrictive elastic bands can cut off circulation, but some degree of compression built in to the sock construction can be supportive and help to protect against deepvein thrombosis. Other people, particularly those with edema , may do better with a loose-fitting sock. Your podiatrist can advise you on what’s right for your particular needs.

Leave a Reply

Your email address will not be published. Required fields are marked *