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[IP] If the Shoe Fits, Diabetics Can Wear It
Note that this study does NOT say anything about charcot foot (a horrible
complication of diabetes that no one should have to suffer with (if anyone
needs info, I'm CURED or at least temporarily CURED of it))
IF THE SHOE FITS, DIABETICS CAN WEAR IT
Custom inserts and shoes are not needed in those with good routine foot
care. MedscapeWire 2002
Read it Here</a>
If the Shoe Fits, Diabetics Can Wear It
Laurie Barclay, MD
NEW YORK (MedscapeWire) May 15 Good-quality, properly fitting shoes may
prevent diabetic foot ulcers just as well as custom therapeutic inserts and
footwear, according to results of a randomized trial published in the May 15
issue of The Journal of the American Medical Association. Still, healthcare
professionals should devote careful attention to routine foot care in
"The results were surprising," lead author Gayle E. Reiber, MPH, PhD, of the
Veterans Affairs (VA) Puget Sound Health Care System and the University of
Washington, says in a news release. "The popular notion among foot
specialists is that therapeutic shoes and inserts should be prescribed
freely to all patients with diabetes and prior foot ulcers. However, this
study did not provide evidence to support this practice."
In this study, researchers randomized 400 men and women with a history of
diabetic foot ulcer to wear extra-depth therapeutic shoes with customized
cork inserts, therapeutic shoes with noncustom polyurethane inserts, or
their own shoes. Patients with severe foot deformities or other special
problems who might benefit from custom-made footwear were excluded. All
subjects wore specially designed slippers when not in their shoes, and all
had access to good-quality healthcare, including visits every 17 weeks with
a team that included a foot-care specialist.
After 2 years, ulcer rates were low in all 3 groups: 15% for those with
customized inserts, 14% for those with standard inserts, and 17% for those
who wore their own shoes. These rates were dramatically lower than those in
earlier European studies.
According to Reiber, the extra attention given these subjects may have
contributed to the overall low rate of ulcers in all 3 groups. Although
careful attention by healthcare professionals may be more important than
therapeutic footwear in preventing ulcers, patients with limited access to
care may benefit from special footwear.
For diabetics, foot-care specialists routinely recommend "depth" shoes
providing extra toe room, along with inserts, which are reimbursable by
Medicare up to $318 per year. "The evidence suggests that a shift in the
diabetic foot-care paradigm may be in order," says researcher Douglas C.
Smith, MD, of the University of Washington.
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