Orthopaedic Guide to Diabetic Foot Care

The statistics surrounding diabetes and diabetic related health issues are staggering. Diabetes is the cause of approximately 60,000 lower extremity amputations performed annually in the U.S.

According to the American Orthopaedic Foot & Ankle Society (AOFAS) many of these amputations are preventable with ongoing, thorough, and proper foot care. To help increase awareness about amputation prevention in diabetic patients, the AOFAS in conjunction with American Diabetes Month, November 2010 re-issued its patient education Guide to Diabetic Foot Care.

The AOFAS Guide to Diabetic Foot Care contains simple, easy to understand answers to basic questions about diabetic foot problems. It also includes a review of daily foot and shoe examination techniques, danger signs for infection, daily washing and foot care protocol, as well as proper shoe fitting advice. The guide is available in English and 20 other languages via the AOFAS website www.aofas.org

Diabetic foot conditions cause more hospital admissions than any other aspect of the disease. According to AOFAS President Keith L. Wapner, MD;

"Individuals with diabetes must be thorough about their foot care in order to prevent many of the serious foot complications associated with diabetes. Diabetic individuals should check their feet daily by inspecting all sides including the bottom; any changes in shape or color, sense of feeling/sensation, painful areas or skin integrity need to be evaluated by an orthopaedic foot and ankle surgeon."

Diabetic Foot Care

In addition to the guide, the AOFAS suggests the following daily foot care routine and infection prevention tips for individuals with diabetes:

• Examine your feet daily; look for signs of swelling, redness, blisters, or cuts in the skin.
• Monitor sensation; brush the foot with a feather or facial tissue to test its ability to feel light touch.
• Wash feet daily in lukewarm water, never hot.
• Dry thoroughly but gently between the toes.
• Trim toe nails straight across with a nail clipper.
• Choose good footwear with cushioned soles and uppers made of soft, breathable material such as leather, not plastic.
• Wear protective shoes, not sandals, to prevent any injuries to feet and toes.
• Never walk barefoot.
• Wear cotton or natural fiber socks; avoid socks or shoes that are too tight.
• Break in new shoes gradually.

Orthopedic Adaptive/Adapted Footwear

Diabetic shoes, sometimes referred to as extra depth, therapeutic shoes or sugar shoes, are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with co-existing foot disease. The diabetic shoes and custom-molded inserts work together as a preventative system to help diabetics avoid foot injuries and improve mobility.

In the United States, diabetic shoes can be covered by Medicare. Medicare Part B (Medical Insurance) covers the furnishing and fitting of either one pair of custom-molded shoes and inserts or one pair of extra-depth shoes each calendar year. Medicare also covers 2 additional pairs of inserts each calendar year for custom-molded shoes and 3 pairs of inserts each calendar year for extra-depth shoes. Medicare will cover shoe modifications instead of inserts - https://www.medicare.gov/coverage/therapeutic-shoes-or-inserts

Socks for people with diabetes are usually designed to be form-fitting and seamless in order to eliminate any potential sources of irritation. The socks might have fibers with some anti-microbial or anti-fungal properties, yet for the most part their main purpose is to not make foot issues related to diabetes any worse.

The AOFAS Guide to Diabetic Foot Care can be found on the AOFAS website, www.aofas.org The site also features a surgeon referral service; making it easy for diabetic patients to find a local orthopaedic surgeon specializing in foot and ankle care.