Why do you need diabetic footwear?
Diabetic Shoes. Orthopedic footwear. Insoles and Orthotics. Why do I need them if I am diabetic? One of the issues with diabetes is that people with diabetes have a tendency to have foot problems due to peripheral neuropathy. Peripheral neuropathy is a condition that is common in people that have diabetes; this is a loss of sensation in the extremities of the limbs. The pain many diabetics feel in their feet is often caused by either poor blood circulation or nerve damage. Diabetic shoes or diabetic footwearperipheral neuropathy. Shoes that do not fit properly that pinch or chafe the feet can lead to blisters and foot injury because the person with diabetes can not feel the injury until it is too late. will literally ease the pain that is caused by the
Combined with other symptoms of diabetes, including poor blood flow and lower immune system response, these effects can lead to severe problems of the feet if the diabetic is not watchful to take proper care of their feet. Skin ulcers, cracked skin and fungal infections can be very hard to take care of for a diabetic, and may not heal correctly without extensive medical care. In some cases, improper foot support can cause bone displacement as well, and in severe cases of poor circulation, amputation of the toes may become necessary. Prevention is definitely your best option in diabetic foot care.
The main method of caring for and controlling the symptoms of the diabetic foot is by controlling the levels of sugar in the blood. However there are many options for proper diabetic foot care that will minimize pain and injury because diabetic foot problems are hard to completely avoid.
An important element in preventing such injuries and pain is a special designed diabetic shoe and specialty insole to help alleviate and/or prevent foot pain and injury. Diabetic shoes are deeper and wider than regular shoes, to make room for special diabetic insoles. It is also important for people with diabetes to have footwear with good air circulation, meaning a lot of diabetic footwear features fabric or sandal-style uppers.
• Diabetic Shoes need to have a breathable construction – diabetic sandals and fabric shoes are good for this.
• Shoes for diabetics should be lightweight
• Deep and wide designs that allow room for custom pedorthic insoles.
• Designs with no interior seams (or covered seams) to prevent rubbing injuries
• Diabetic Shoes need a spacious box style toe to prevent pinching or squeezing of the toes.
• Velcro or elastic to easily adjust the fit, to prevent the diabetic shoe from moving around on the feet.
Shoes and custom insoles which are specially designed to meet the requirements of the diabetics’ feet will often be partially or fully covered by your heath care insurance provider, offsetting the cost of the customization.
Your feet really need to be looked after, if you are diabetic. There is a lot of good, comfortable and fashionable footwear available. If you suffer from diabetes, look into a pair of these shoes, orthotics, and socks. I have found these type of diabetic products at a web site featuring Diabetic Footwear , although, a quick search of the internet will bring up more.
Diabetic Shoes & Orthotics
Diabetic Shoes
Diabetic shoes, also known as therapeutic shoes, and customized orthotics work together as a preventative system to help diabetics avoid foot injuries and improve mobility. The primary goal of therapeutic footwear is to prevent complications, such as: strain, ulcers, calluses, or even amputations for patients with diabetes and poor circulation.
When looking for diabetic shoes, keep the following tips in mind:
• Your diabetic shoes should have a high and wide space in the toe box (toe area of the shoe) to prevent chafing and pinching that can harm the toes.
• Your diabetic shoes should fit well. A diabetic shoe with an adjustable closure — such as hook-and-loop — often provides the best fit since you can make it larger or smaller as needed.
• Remember to do your shoe shopping in the afternoon. Feet tend to swell up in the afternoon making shoes bought in the morning feel too tight.
• Your diabetic shoes should have comfortable yet removable insoles for fitting flexibility and the option to insert orthotics.
• Your diabetic shoes should have a firm heel to aid in support and stability.
• Your diabetic shoes should protect your feet.
• As diabetics are at great risk for developing friction related injuries we recommend shoes with rocker soles, which are designed to reduce pressure in all foot areas as the shoe “rocks” from heel-strike through toe-off due to a curved sole thus reducing pressure on the foot, ankle, toes, and metatarsals.
• It’s also important to remember to wear seamless diabetes socks and stockings along with your diabetic shoes to keep moisture away from your feet.
Orthotics
Orthotics also play an important role in diabetic foot care. Orthotics designed with Plastazote foam, the #1 material for protecting the insensitive diabetic foot, are usually recommended. Plastazote is a material designed to accommodate pressure hot spots by conforming to heat and pressure. By customizing to the foot, Plastazote provides the comfort and protection needed in diabetic foot care.
Our trained staff at Hoagland Pharmacy will gladly assist you in choosing the correct footwear or orthotics for your specific need. We can special order shoes as necessary and are able to bill either Medicare or Medicaid for those who meet the individual insurance requirements.
iStep Machine
Aetrex’s iStep is the most revolutionary digital foot analysis device ever created and iStep tests are recommended for all people who want to feel great on their feet. In less than 30 seconds the iStep will capture your foot type, pressure points and shoe size and then help recommend the ideal footwear and orthotics for your individual needs.
This patented technology features 3,744 Gold plated barometric sensors that measure the pressure exerted by your foot every .25 cm(2). The high concentration of sensors allows the device to perform a precise reading, even for a small child. Amazingly, this compact device also incorporates 1,326 infrared LEDs and Receptors that are aligned every half millimeter to ensure unmatched accuracy when measuring your foot. Images can be viewed in two or three dimensions and tests can be done in either static or dynamic format.
Our customer service staff at Hoagland Pharmacy will gladly assist you in the iStep service. Come in for a free foot scan today!
Diabetic Shoes and Inserts
Diabetic Patients Should Beware of Abuse and Fraud
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Shoes and Inserts for the Diabetic Patient
As a Diabetic patient you should be cautious when procuring therapeutic shoes and inserts under the Medicare Therapeutic Shoe Bill to insure you are receiving the level of service intended. The evaluation, measuring, casting, and fitting of these devices in a clinical setting is a process that involves considerable personal contact between the practitioner and the patient. This is as it should be. Care is taken by the provider of these devices to insure proper fit and function. Patient education and follow up is done in the office. Adjustments are often needed after initial fitting. The potential complications which can follow improper fitting of these devices can be serious. Modifications and adjustments to the shoes and inserts are sometimes needed. These can only be done by someone with the proper training and equipment.
There is a lot of money to be made in the diabetic shoe business by high volume, minimal patient contact operations. These companies often use the Internet, to solicit new customers. They may send someone to measure and cast you - they may not. Often the shoes are mailed to you to try on yourself and you are expected to call them if there are any "problems." These businesses are receiving the same reimbursement from medicare for your care that the certified and licensed professional receives for spending time with you in his or her clinical office. But, you the patient are clearly not receiving the level of care intended by the Medicare therapeutic Shoe bill.
Diabetic shoes are sometimes sold as a sideline in a retail establishment such as a pharmacy. These companies usually do not have a any fitting stock or the necessary facilities for private and comprehensive evaluation and fitting. Rarely will they have the equipment needed for modification and adjustment. Their personnel may lack the training to be considered a "qualified individual" under the Medicare therapeutic Shoe Bill. In short, these businesses have not made a significant investment in patient care, and diabetic shoes and inserts are in effect, just another retail item on their shelf. Once again, there is a lot of money to be made when the provider's investment is confined to a few display shoes and a measuring stick, but the question must be repeated: "Are you receiving the level of care that Medicare intends?"
The following quote is from the LMRP for Therapeutic Shoes for Persons with Diabetes on the Region B Medicare Durable Medical equipment Website (with the full text available on the Internet at the link above. It specifies the professions that are trained to fit therapeutic shoes.
"The particular type of footwear (shoes, inserts, modifications)which is necessary must be prescribed by a podiatrist or other qualified physician, knowledgeable in the fitting of diabetic shoes and inserts. The footwear must be fitted and furnished by a podiatrist, or other qualified individual such as a pedorthist,orthotist or prosthetist. The certifying physician (i.e., the physician who manages the systemic diabetic condition) may not furnish the footwear unless he/she practices in a defined rural area or a defined health professional shortage area. The prescribing physician (podiatrist or other qualified physician) can be the supplier (i.e., the one who furnishes the footwear)."
Medicare does not intend to provide free shoes and inserts to all diabetics. The physician responsible for your primary diabetic care must certify additional medical complications, attesting that you really need special shoes. Prefabricated inserts are sometimes indicated- not every patient needs the custom made inserts. The custom inserts cost Medicare and the tax payer more and of course provide additional income to the provider. If the additional cost is not justified, this is what many would call Medicare abuse. Some outfits will bill medicare on your behave for "custom diabetic shoes" while only providing off the shelf shoes slightly modified or fitted with custom inserts. This is what many would call Medicare fraud.
The state of Illinois and others have laws which also appear to provide direction as to who is qualified to dispense and fit therapeutic shoes in their respective jurisdictions. Orthotic, Prosthetics, and Pedorthics Act - Illinois
Yes, be cautious when it comes to therapeutic shoes and inserts. Your health and your pocketbook is involved.
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