Diabetic Foot Care-The Right Pair of Shoes Can Prevent Limb Loss

Diabetes is the 7th leading cause of death in the nation. It affects more than 16 million people in America, and that number is increasing every year. More than half of the people with diabetes do not even realize they have the disease. It can lead to stroke, blindness, and very often the loss of lower extremities. Last year there were over 100,000 lower limb amputations related to diabetes. Dr. Kenneth Rheem of the Diabetic Foot Center in San Marcos, California explains. "There is a link between diabetes and the foot. And it's a very strong link mostly because we walk on the foot. Due to a condition called neuropathy, the diabetic experiences a loss of sensation in the foot, and will develop sores because they don't feel when they walk on a stone or walk on a needle or we are walking in bad shoes, or are walking without support in the shoe. They just cannot feel it, so we get injured and we don't have enough circulation as diabetics to heal the injury. This is the problem."

But many of those injuries can be prevented with a little education and the right pair of shoes. The Centers for Disease Control the CDC estimated that there were 90,000 lower limb amputations in 2002, and the World Health Organization says that 85% of those could be preventable with proper foot care and foot wear. And all though orthotics and specialty shoes for the diabetic population have been around for a long time, many patients refuse to wear them. "In my practice they are so reticent to go in to a shoe, when in fact the industry has changed so much. We have shoes that are so cosmetically acceptable to the patient I want them to have an open mind towards using proper shoes and healthy foot wear."

Says doctor Rheem, in fact one company called FootEFX sells a line of shoes specially designed for the diabetic that anyone would be hard pressed to distinguish form ordinary foot ware. Steve Lebow with FootEFX. "A diabetic shoe differs from a normal shoe in a couple of different ways they have a larger toe box that allows for room if the foot swells. They have an interior lining, which has wick effect, it pulls moisture away from the foot, and they are also created in three different widths to accommodate the diabetic foot. These shoes are also designed with material to prevent shearing from occurring with the diabetic foot in there." Today there are many manufacturers that design shoes with these properties that aesthetically differ very little from traditional athletic or walking shoes.

It has been documented that patients who were wheelchair bound prior to wearing the proper foot ware, have been able to get up and walk after using a properly fitted pair of diabetic shoes. Doctors say that is one of the keys to recovery from and preventing future ulcerations - the ability to walk normally and regularly. Once the patient starts walking this helps to improve the circulation, and this has an upward spiral effect instead of the downward spiral effect that occurs with being wheel chair or bed bound.

Of course proper shoes are only one of the ways the diabetic needs to protect their feet and prevent limb loss. In addition to an annual foot examination to identify high-risk foot conditions, doctors recommend all diabetics:

· Wash your feet every day with lukewarm (not hot) water and mild soap.

· Dry your feet well, especially between the toes. Use a soft towel and pat gently; don't rub.

· Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to
your doctor about how to treat it.

· Keep your feet dry by dusting them with a non-medicated powder before putting on shoes, socks or stockings.

· Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor at the very first sign of redness, swelling, pain that doesn't go away, or numbness or tingling in any part of your foot.

· Don't treat calluses, corns or bunions without talking to your doctor first.

· Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them.

· Don't let your feet get too hot or too cold.

· Don't go barefoot.

Being informed and taking the time to prevent problems before they occur can break the foothold this deadly disease has on our population.