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Direct Diabetes Supplies is currently developing a Diabetic Shoe Program in conjunction with Medicare. Please contact us for details of when this will be available.
Foot Care Facts
Proper foot care is an essential component of diabetes management. Even ordinary problems like callusing can get worse and lead to serious complications. Studies have shown that well fitted diabetes shoes and moldable inserts can substantially reduce the development of ulcers and sores that could avoid more serious complications like hospitalization or an amputation.
Medicare will cover 80% of the cost of one pair of shoes and three pair of inserts per year. Any deductibles or co-payments are the patient’s responsibility but are often covered by supplemental insurance. Here are the requirements for coverage:
While these requirements seem daunting, our professionally trained staff can assist in the qualification for these items or find a diabetes shoe provider who can help you.
Foot Care Tips
There are many things you can do to keep your feet healthy.
Prevention of Foot Problems
A patient with diabetes should inspect their feet everyday and seek immediate help if they sustain a foot injury. Make sure the patient asks their health provider to check their feet no less than once per year and on each visit if the patient has known foot problems. It is helpful while waiting for the doctor in the examination room, for the patient to take their shoes and socks off as a reminder to the doctor to perform the foot exam. The doctor should also give the patient a list of “dos and don’ts” of foot care. Ask for these foot care tips to help get started on better foot health.
If the patient has an ingrown nail or break in their skin, they should see a doctor as soon as possible. Also, they should let their doctor know if there are changes in foot color, shape, or they just feel different (for example, becomes less sensitive or hurts). If the patient has corns or calluses they should always get professional help with trimming them.
Foot Complications
Neuropathy
Although it can hurt, diabetic nerve damage can also lessen your ability to feel pain, heat, and cold. Loss of feeling often means you may not feel a foot injury. You could have a tack or stone in your shoe and walk on it all day without knowing. You could get a blister and not feel it. You might not notice a foot injury until the skin breaks down and becomes infected.
Nerve damage can also lead to changes in the shape of your feet and toes. Ask you health care provider about special therapeutic shoes, rather than forcing deformed feet and toes into regular shoes.
Skin Changes
Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. The problem is that the nerves that control the oil and moisture in your feet no longer work.
After bathing, dry your feet and seal in the remaining moisture with a thin coat of plain petroleum jelly, an unscented hand cream, or other such products.
Do not put oils or creams between your toes. The extra moisture can lead to infection. Also, don’t soak your feet- that can dry your skin.
Calluses
Calluses occur more often and build up faster on the feet of people with diabetes. This is because there are high-pressure areas under the foot. Too much callus may mean that you will need therapeutic shoes and inserts.
Calluses, if not trimmed, get very thick, break down, turn into ulcers. (Open sores). Never try to cut calluses or corns yourself- this can lead to ulcers and infection. Let your health care provider cut your calluses. Using a pumice stone every day will help keep calluses under control. It is best to use the pumice stone on wet skin. Put on lotion right after you use the pumice stone.
Foot Ulcers
Ulcers occur most often on the ball of the foot or on the bottom of the big toe. Ulcers on the sides of the foot are usually due to poorly fitting shoes. Remember, even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Neglecting ulcers can results in infections, which in turn can lead to loss of a limb.
Poor Circulation
Poor circulation (blood flow) can make your foot less able to fight infection and to heal. Diabetes causes blood vessels of the foot and leg to narrow and harden. You can control some of the things that cause poor blood flow. Don’t smoke- smoking makes arteries harden faster. Also, follow your health care provider’s advice for keeping your blood pressure and cholesterol under control.
If your feet are cold, you may be tempted to warm them. Unfortunately, if your feet cannot feel heat, it is easy for you to burn them with hot water, hot water bottles, or heating pads. The best way to help cold feet is to wear warm socks.
Exercise is good for poor circulation. It stimulates blood flow in the legs and feet. Walk in sturdy, good-fitting, comfortable shoes. Don’t walk when you have open sores.
Amputation
People with diabetes are far more likely to have a foot or leg amputated than other people. Why? Many people with diabetes have artery disease, which reduces blood flow to the feet. Also, many people with diabetes have nerve disease, which reduces sensation. Together, these problems make it easy to get ulcers and infections that may lead to amputation. Most amputations are preventable with regular care and proper footwear
Take good care of your feet and do not hesitate to see your doctor with any foot problems. Ask about prescription shoes that are covered by Medicare and other insurance. Always follow your health provider’s advice when caring for ulcers or other foot problems.
One of the biggest threats to your feet is smoking. Smoking affects small blood vessels. It can cause decreased blood flow to the feet and make wounds heal slowly. A lot of people with diabetes who need amputations are smokers.
Visit the American Diabetes Association website for more information about diabetes health and resources.
Steps to Health So your doctor has just instructed you to start a diet and exercise program. One of the easiest and most cost effective exercise programs is walking. You will need to discuss with your health care provider the right program for you. There have been many studies done that show that a pedometer (step counter) is a great motivator to keep you walking. It will track the number of steps you take and the more sophisticated ones will monitor many other features like calories burned. Many show that regular physical activity has been associated with a reduced risk for cardiovascular disease, diabetes, and death in the general population. Additionally walking as well as other forms of exercise were key components of lifestyle changes shown to prevent progression to diabetes among people with impaired glucose tolerance (those at great risk for developing diabetes). Overall the studies have also shown that the physical activity lowers A1c’s, blood pressure, improved lipids as well as moderate weight loss. In the Diabetes Prevention Program is showed that 3234 people who were pre-diabetic, those who walked or exercised five times per week for 30 minutes lost 5-7% of their body weight and reduced their risk of diabetes by 58%. For those over the age of 60, the reduction in diabetes risk was 71%, better than any drug used in the study. So get a partner and start your walking program today with your pedometers to keep you motivated. This is a great way to get the entire family on the move. Please review our diabetes shoe program if you are a Medicare Part B recipient. We also suggest reviewing the pedometer and shoe product line at www.CarePlusPartners.com to see diabetes appropriate footwear if you are not eligible for the Medicare Part B shoe benefit. Remember, a properly fitted shoe is critical for patient with diabetes. Here are some comments from patients involved in the Diabetes in Control Study who used pedometers to assist them with their exercise program: Patient Comments:
Resource: Diabetes in Control
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