It is well documented that many patients I see in my NYC podiatry office have at least one foot, and it is our stated goal to maintain that status for as long as possible. Diabetic patients are especially vulnerable to many complications involving the foot, specifically due to compromised circulation and sensation. These patients are at a much higher risk of ulceration and amputation, and the treatment of diabetic foot wounds is complex and expensive. The prevention of diabetic foot wounds, however, is simple and relatively cheap, like my uncle Ira.
As we have discussed before, it is critically important for all diabetics to see a NYC podiatrist early and often, preferably before any complications manifest. There is a wide body of research demonstrating that just by seeing a podiatrist on a regular basis for routine diabetic foot care and inspection of the foot, the rate of diabetic foot ulcers and even worse complications dramatically decreases. And there is also good evidence that a well-fitting shoe can prevent complications. In fact, a tight shoe is the most common inciting factor in the development of a diabetic foot ulcer and amputation. In my NYC podiatry practice, I’ve seen diabetic patients wear a tight shoe, which then causes a blister, which then, because of decreased sensation in the foot from diabetic neuropathy, leads to a bone infection, which is a devastating complication in any foot. However a wide, extra-deep shoe with a good orthotic insole is effective at preventing complications. How effective? In one recent study, the use of a custom orthotic in a population of diabetics with a history of ulceration and amputation reduced the re-ulceration rate from 79% to 15% and the amputation rate from 54% to 6%! &In these days of spiraling medical costs, lack of preventative care for diabetics, and health care policy changes, I think we can all look to the use of an orthotic in diabetic foot patients as an inexpensive and simple way to prevent a complex, expensive and devastating complication.
And, by the way, these shoes don’t have to be the old grandma orthopedic clunkers with laces on the sides (although those are available if it really turns you on). The diabetic shoes of today are virtually indiscernible from regular shoes - same styles, brands, and types with some additional qualifications such as increased room in the toe box and more shock-absorbing materials. And in the who-knew-the-government-still-has-a-brain department, Medicare and many private insurers will fully cover the cost for one pair of diabetic shoes and three pairs of insoles per year. Shocking, indeed.
So if you are diabetic and have feet, let’s do our best to maintain that status. Stop in for an evaluation and some nice shoes.
See you in the office.
Ernest Isaacson
