In my practice, I treat a lot of diabetic patients, and I see a lot of diabetic wounds. In this case, the wounds are called diabetic foot ulcers.
When evaluating diabetic foot ulcers, some of the things we look for as foot specialists are signs of infection, size of the wound, lab tests, blood sugar levels, shoes, and circulation of the feet and legs. All of these are important. Also, getting a good history from the patient is very important. We need to know how long the wound has been present, what medications have been given, and if any other treatments have been rendered yet.
As a podiatist, my main goal is to save my patients' feet. So this is a very important topic for me. We need the patient to help us do our job to heal the diabetic foot ulcer. Whether that means staying off of the foot or wearing a special boot, the doctor knows best when it comes to healing the foot ulcer. The longer the ulcer remains open, the higher incidence of infection (whether it be in the soft tissues or in the bone). And once it goes into the bone, that is when amputation occurs.
Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
626-442-1223
www.elmontefootdoctor.com
Like our facebook fan page: http://www.facebook.com/drmichelesummerscolondpm
Please feel free to email me if you have any questions or if you would like to schedule an appointment, or you can visit our website or call our office.
dr.michele.colon@gmail.com
Showing posts with label diabetic shoes. Show all posts
Showing posts with label diabetic shoes. Show all posts
Friday, September 28, 2012
Monday, November 7, 2011
Diabetic Shoes…”They are not just for diabetics anymore.”
The diagnosis of “diabetes” sends shivers thru most people. While definitely not a death sentence as it has been in the past, the word conjures up the images of needles, tasteless food, the possibility of dialysis and blindness. While this blog won’t attempt to delve into the finer points of the disease, it will focus on just one aspect that will make life easier and attempt to make you aware how to make your diabetes a bit “easier on your feet”.
A common side effect of diabetes is a phenomenon called “diabetic neuropathy”. This is a disease entity that causes your feet to lose the normal sensation of pressure, pain and proprioception. While this might not seem like a big deal compared to other aspects of the disease, if left unchecked, it can lead to infection, amputation and even death.
In addition to checking your feet every day and keeping them clean, warm and dry, diabetic shoes are a simple thing to help extend the life of your neuropathic feet.
The shoes themselves are composed and function in several ways to accomplish this.
First and foremost. If you believe your feet to be neuropathic, you need to visit a or certified Pedorthist to make sure the shape of the shoes fit the shape of your feet. Easily said but not easily done by most people. The diabetic shoes help to accomplish this in several ways.
1) The shape : This is easily done as the shoes have a wider , and higher toe box to make sure that the toes are not being rubbed into the front or top of the shoes. This prevents the formation of blisters and callouses , that in a diabetic can and will lead to disaster. The soles are also a bit more substantial to allow better wear and more shock absorption, as well as a firmer ”footprint “ of the shoe as it contacts the ground.
2) The insoles: These are composed of several special material that cushion, comfort and cradle the foot so that with each step, the foot does not rub against the inside of the shoe. These materials are often “heat sensitive” and form impressions of things such as depressed metatarsals and help to distribute the weight of the foot in a more even pattern as the foot goes thru the gait cycle. Your foot specialist will frequently check these insoles to make sure they are wearing properly, and change them several times a year.
3) Fastening system or “Laces vs. Velcro straps”: If you can’t feel pressure on your feet how is one to know if they are laced too tightly?? Diabetic shoes usually have either one or two wide straps with which the use of Velcro not only make the shoes easy to lace, but help to make sure they are not too tight on the top of the feet. Let’s not forget that neuropathy can also affect the hand as well as the feet. If you can’t feel your fingers, how would one be able to tie shoe laces. This fastening system is also a tremendous boon for the millions of people with moderate to severe arthritis).
To sum up… The triad of daily foot inspection, proper sock s and use of diabetic shoes will go miles in helping to keep your feet ready to take that next big step toward tomorrow, as you deal with the daily struggle against diabetes.
Blog submitted by Rob Kosofsky DPM.
A common side effect of diabetes is a phenomenon called “diabetic neuropathy”. This is a disease entity that causes your feet to lose the normal sensation of pressure, pain and proprioception. While this might not seem like a big deal compared to other aspects of the disease, if left unchecked, it can lead to infection, amputation and even death.
In addition to checking your feet every day and keeping them clean, warm and dry, diabetic shoes are a simple thing to help extend the life of your neuropathic feet.
The shoes themselves are composed and function in several ways to accomplish this.
First and foremost. If you believe your feet to be neuropathic, you need to visit a or certified Pedorthist to make sure the shape of the shoes fit the shape of your feet. Easily said but not easily done by most people. The diabetic shoes help to accomplish this in several ways.
1) The shape : This is easily done as the shoes have a wider , and higher toe box to make sure that the toes are not being rubbed into the front or top of the shoes. This prevents the formation of blisters and callouses , that in a diabetic can and will lead to disaster. The soles are also a bit more substantial to allow better wear and more shock absorption, as well as a firmer ”footprint “ of the shoe as it contacts the ground.
2) The insoles: These are composed of several special material that cushion, comfort and cradle the foot so that with each step, the foot does not rub against the inside of the shoe. These materials are often “heat sensitive” and form impressions of things such as depressed metatarsals and help to distribute the weight of the foot in a more even pattern as the foot goes thru the gait cycle. Your foot specialist will frequently check these insoles to make sure they are wearing properly, and change them several times a year.
3) Fastening system or “Laces vs. Velcro straps”: If you can’t feel pressure on your feet how is one to know if they are laced too tightly?? Diabetic shoes usually have either one or two wide straps with which the use of Velcro not only make the shoes easy to lace, but help to make sure they are not too tight on the top of the feet. Let’s not forget that neuropathy can also affect the hand as well as the feet. If you can’t feel your fingers, how would one be able to tie shoe laces. This fastening system is also a tremendous boon for the millions of people with moderate to severe arthritis).
To sum up… The triad of daily foot inspection, proper sock s and use of diabetic shoes will go miles in helping to keep your feet ready to take that next big step toward tomorrow, as you deal with the daily struggle against diabetes.
Blog submitted by Rob Kosofsky DPM.
Wednesday, October 19, 2011
Monday, October 25, 2010
Why Do Diabetics Lose Their Legs?
You have had problems with your foot for years. Your doctor now tells you that the foot needs to be amputated. How did this happen? Do you have to go through with the surgery? What will happen if you keep your foot?
Diabetes is a devastating disease. It can be managed, and many of the complications of diabetes are preventable. This takes much dedication of the patient and a team of doctors. Discovering you have diabetes and making life changes to prevent life threatening complication of the disease is very difficult. Thus, many people still run into problems associated to diabetes. Foot problems are among one the most common complications. 70% of all limb amputations are due to diabetes!
There are several reasons diabetics have foot problems but let’s talk about the three big causes. When the nerves are exposed to high levels of glucose or high blood sugars, they are slowly damaged. Thus, many diabetics suffer from peripheral neuropathy, a disease in which they slowly lose protective sensation in the feet. This can be very dangerous. I have had patients who had glass, needles, tacks and other objects stuck in their foot and they never remember how it happened. I have also had patients burn themselves in the bath tub. Their feet can no longer perceive temperature and they can easily burn or freeze their feet!
Diabetics also suffer from poor circulation. Blood carries many nutrients and oxygen that is essential to keep tissues healthy. Poor blood supply makes it extremely difficult for damaged tissues to heal. When a patient has a wound or ulcer on the foot, their poor blood supply makes it is so hard for the area to heal. Diabetics also have a compromised immune system. The body is weakened in its defense mechanism to fight off infections. Infections kill good tissues and leaves dead necrotic tissue behind. Infections can spread very fast from soft tissue to bone and joints and even into the blood supply. Infections can be life threatening.
When the threat of infection is too severe and can no longer be managed by antibiotics, the doctor may suggest an amputation. To remove all or as much dead tissue as possible helps prevent the infection spreading to other areas of the body. A doctor may also suggest amputation if the foot has become non-functional.
The thought of losing a part of your body is a very difficult concept to deal with. It is not uncommon for the doctor to suggest therapy to help the patient cope with process of surgery and rehabilitation. It is important to note that amputations are a part of medical plan to keep you as health as possible. It is important to discuss your fears and concerns with your doctor and to seek second opinions if you do not feel comfortable with your doctor’s advice. It is your leg and should be fully aware to the risk and consequences of keeping and amputating portions of your limb.
Diabetes is a devastating disease. It can be managed, and many of the complications of diabetes are preventable. This takes much dedication of the patient and a team of doctors. Discovering you have diabetes and making life changes to prevent life threatening complication of the disease is very difficult. Thus, many people still run into problems associated to diabetes. Foot problems are among one the most common complications. 70% of all limb amputations are due to diabetes!
There are several reasons diabetics have foot problems but let’s talk about the three big causes. When the nerves are exposed to high levels of glucose or high blood sugars, they are slowly damaged. Thus, many diabetics suffer from peripheral neuropathy, a disease in which they slowly lose protective sensation in the feet. This can be very dangerous. I have had patients who had glass, needles, tacks and other objects stuck in their foot and they never remember how it happened. I have also had patients burn themselves in the bath tub. Their feet can no longer perceive temperature and they can easily burn or freeze their feet!
Diabetics also suffer from poor circulation. Blood carries many nutrients and oxygen that is essential to keep tissues healthy. Poor blood supply makes it extremely difficult for damaged tissues to heal. When a patient has a wound or ulcer on the foot, their poor blood supply makes it is so hard for the area to heal. Diabetics also have a compromised immune system. The body is weakened in its defense mechanism to fight off infections. Infections kill good tissues and leaves dead necrotic tissue behind. Infections can spread very fast from soft tissue to bone and joints and even into the blood supply. Infections can be life threatening.
When the threat of infection is too severe and can no longer be managed by antibiotics, the doctor may suggest an amputation. To remove all or as much dead tissue as possible helps prevent the infection spreading to other areas of the body. A doctor may also suggest amputation if the foot has become non-functional.
The thought of losing a part of your body is a very difficult concept to deal with. It is not uncommon for the doctor to suggest therapy to help the patient cope with process of surgery and rehabilitation. It is important to note that amputations are a part of medical plan to keep you as health as possible. It is important to discuss your fears and concerns with your doctor and to seek second opinions if you do not feel comfortable with your doctor’s advice. It is your leg and should be fully aware to the risk and consequences of keeping and amputating portions of your limb.
Thursday, April 23, 2009
Obtaining Proper Shoes Through Medicare
Over the years, I have found that unfortunately, one of the best kept secrets among patients with diabetes is the Medicare Therapeutic Shoe Program. People with diabetes are instructed that they need to make sure they wear proper shoes. This is a program that makes this possible! Per Medicare guidelines, patients who qualify can receive one pair of shoes per calendar year, and three pair of accomodative inserts. Three pair of inserts are allowed because over time, they lose their ability to cushion the feet. By dispensing three pair, patients can change the inserts every 4 months, thus insuring that they always have proper cushioning and support in their shoes. While not every diabetic patients on Medicare qualify for this program, the truth is that many do qualify, and there are many who qualify who are not taking advantage of this program.
For a shoe to qualify for the Medicare Therapeutic Shoe Program, it needs to meet certain criteria. These include:
For a shoe to qualify for the Medicare Therapeutic Shoe Program, it needs to meet certain criteria. These include:
- Have more interior depth than a normal shoe, which allows for at 3/16" accomodative insert.
- Must be made from leather or a material of equal quality
- Must have some form of closure (usually laces or a Velcro closure)
- Must be available in full and half sizes
- Must be available in at least 3 widths.
Many diabetic patients are concerned that the shoes will be big, heavy or unattractive to wear. This is simply not the case. The variety of shoes styles available means that it is extremely rare not to be able to find a pair of shoes that meets your need, both medically and aesthetically. On top of that, the shoes are designed to be comfortable!
To qualify for shoes, you need to be examined by your doctor to see if you meet Medicare's guidelines for receiving the shoes. Once it's determined that you qualify, a letter will need to be received from your primary care physician who will certify that you are diabetic and would benefit from receiving the shoes. This is one of the few programs that Medicare offers that is intended to be preventative. Studies have shown that by wearing proper shoes, the risk of developing an ulceration in the foot can be greatly reduced. In other words, you don't have to already have had a foot ulcer to qualify, you just need to be at risk of developing an ulcer. You also do not have to be on insulin to qualify.
Most offices will do a fitting, then order the shoes for you. Once the shoes are shipped to the office, you will be contacted for shoe dispensing. In our office, we recommend that you wear the shoes indoors until you are certain that they are right for you. If for any reason they are not, they can be returned for a more appropriate size or style.
If you have not taken advantage of this program, talk to your podiatrist & see if it is something that you would benefit from. And if you have received a pair of shoes in the past, perhaps it's time for a new pair. Your feet will thank you!
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