Diabetes affects so many aspects of your life, from head to toe. Or maybe we should say, ‘from toe to head’. Many of our patients here in DeSoto as well as in Sunnyvale or Dallas— at least those patients who see the doctor regularly, and keep their blood sugar under control, and monitor their health— say they feel no adverse effects from their diabetes, although they are certainly aware of the disease. When it starts to affect the feet, however, it’s no longer possible to say diabetes hasn’t changed your life.
If you’ve had diabetes for any length of time, you already know that foot sores are a concern, for two reasons. One, lack of sensation in diabetic feet may make you oblivious to injuries such as sores, cuts or infections. Two, restricted blood flow to the extremities means that an injury may be slow to heal.
So what can be done?
- You are your own best monitor. Check your feet every day for signs of damage.
- See the doctor if you notice a wound that is swollen or red, or oozes a discharge. It might indicate infection.
- Wash the feet daily and dry them thoroughly. Wear clean, dry socks each day to prevent fungal infections.
- Keep your toenails trimmed— but not too short— and let our staff handle corns and calluses.
- If your feet are causing some discomfort— chafing against the sides of your shoes, or showing blisters or welts— call one of our clinics in DeSoto, Sunnyvale and Dallas to speak with the doctor about whether you need therapeutic footwear.
Medicare Will Pay For Diabetic Shoes
Any patient with diabetes is eligible for one pair of custom shoes and inserts, or one pair of extra-depth shoes each calendar year, through Medicare Part B. The doctor must first certify that you have been diagnosed with diabetes and that you need therapeutic shoes or inserts. Depth inlay gives more cushioning to the feet than ordinary footwear. Since these shoes can cost up to $300, it’s good to investigate whether you qualify for Medicare reimbursement beforehand.
Another kind of therapeutic footwear is called a boot. These shoes are molded around the patient’s foot to provide constant, total contact. The boot is designed for patients who need intensive care of their wounded feet. But one study found that people who were able to remove the boot spend only about one-third of their time wearing it. Not surprisingly, those patients took quite a bit longer to heal.
Research shows that ulcers that aren’t infected tend to heal in six to eight weeks. In one study, patients who wore a boot (cast) healed more quickly and more completely than those who wore a removable cast or a half-shoe even though both groups claimed to be wearing the boot non-stop.
Don’t Gamble With Your Health
Once you make a commitment to wearing therapeutic footwear, it’s a mistake to think you can sometimes forget about the whole diabetic thing. One of our patients (we’ll call him Edward) is a middle-aged businessman who was diagnosed with type 2 diabetes. In 2012, he developed a persistent infection in his foot, so he started wearing special therapeutic shoes. That same summer, he attended a conference in Las Vegas and he ditched the orthopedic shoes in favor of something more stylish. After dinner, his companions proposed a long, late-evening walk back to the hotel. For the next four months, Edward said, he paid the price for that walk. He was on crutches until Christmas.
Edward has since met other diabetics who’ve fared worse than he did. One of his friends broke his toe, and never felt a thing. Only his doctor saved him from a foot amputation.
These days, Edward says ‘No thanks’ to taking chances with his feet. ‘I’ll test my luck in Vegas,’ he says. ‘My feet are too important to me.’