Diabetic Shoe Fitting

Diabetic shoes sometimes referred to as extra depth or therapeutic shoes, are specially designed shoes or inserts intended to reduce the risk of skin breakdown in diabetics with co-existing foot disease.

DECREASED SENSITIVITY

People with decreased sensitivity in their feet may have a false sense of security as to how much at risk their feet actually are. An ulcer under the foot can develop in a couple of hours.

THERAPEUTIC FOOTWEAR

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. In addition to meeting strict guidelines, diabetic shoes must be prescribed by a physician and fit by a qualified individual. The shoes must also be equipped with a removable orthotic. Foot orthotics are devices such as shoe inserts, arch supports, or shoe fillers such as lifts, wedges and heels. The diabetic shoes and customized insoles work together as a preventative system to help diabetics avoid foot injuries.

UNDERSTANDING THE BENEFITS

The benefits of therapeutic shoes so you can establish your goals and to achieve the desired benefits.

What you Need To Know

Every year about 38,000 people with diabetes have a lower extremity amputation. Therapeutic shoes are prescribed by clinicians specializing in foot care to prevent foot ulcerations and amputations among at-risk patients with diabetes. Medicare ran a 3-year demonstration of a therapeutic-shoe benefit for beneficiaries with diabetes and in May 1993 Medicare added the benefit nationwide.

What does Medicare Cover?

Medicare covers therapeutic shoes and inserts for beneficiaries who have Medicare Part B, have diabetes, and are being treated under a comprehensive plan of care. This benefit includes either 1 pair of custom-molded (including inserts provided with such shoes) and two additional pairs of inserts, or one pair of depth shoes and three pairs of inserts (not including the non-customized removable inserts provided with such shoes). Medicare beneficiaries pay 20% of the Medicare-approved amount after meeting the yearly Medical Part B deductible.

DEVELOPING FOOT ULCERS?

Proper foot care is an important part of diabetes management. In fact, diabetics are at an extremely increased risk of serious foot disorders. Foot problems are the most common diabetes complication leading to hospitalizations. Ulcers or sores on the feet can be caused by improper shoe gear that can result in infection and possible amputations.

Studies show that the well fitted diabetic shoes with molded insoles reduce the development of these ulcers and sores. By starting preventative measures early, it is possible to avoid later foot complications and will enable you to maintain an independent active lifestyle.

What is Medical Nutritional Therapy?

Medical Nutrition Therapy, often abbreviated as MNT, is an evidence-based medical approach to treating certain chronic conditions through the use of an individually-tailored nutrition plan. This nutrition plan is ordered and approved by a primary care physician and implemented by a Registered Dietitian.

Do I need Medical Nutrition Therapy?

Healthy eating is an important part of everything we do. Food gives our bodies and our minds the fuel to think clearly and execute daily tasks.

Healthy eating affects every facet of our lives, from how we look, to how we feel, to how we sleep, to how we move, and even to how we think.

What we eat affects our lives in so many ways, it’s important to have regular check-ups and interventions with a dietitian to assure that your diet is in good condition in the same way that you have check-ups and interventions with a doctor to make sure your body is in good condition.

MNT can play a life-changing role in reducing complications associated with certain chronic conditions, such and Type 2 Diabetes and Chronic Kidney Disease (CKD).

STRENGTHEN YOUR BODY
STRENGTHEN YOUR HEART

Medical Nutrition Therapy
LOWERS BLOOD PRESSURE

Pressure in adults with hypertension. Studies show that MNT provided for six months or less leads to significant reductions in both systolic and diastolic blood pressure.

STRENGTHEN YOUR SOUL
MNT IMPROVES A1C SCORES

Studies evaluating the effectiveness of MNT in patients with diabetes reported reductions in A1C levels ranging from 0.25% to 2.9%. MNT has also been shown to delay and prevent dialysis in patients with CKD.

MNT interventions, dietitians counsel patients on behavioral and lifestyle changes required to positively affect long-term eating habits and health.

Every dietitian visit includes both an assessment and an education portion. During the assessment, dietitians perform a kitchen inspection, evaluate the patient’s physical state, and assess overall nutritional needs. During the educational portion, dietitians will take the information they’ve gathered in the assessment and provide patient-centered goals and individualized nutrition recommendations. Together with the patient, dietitians plan and implement nutrition interventions that meet patient needs and establishes a plan for positive change.

Does Medicare cover MNT?
Medicare covers 100% of the cost of Medical Nutrition Therapy for patients with diabetes and Chronic Kidney Disease (CKD). Patients with CKD do not qualify if they are already on dialysis.

Diabetic Foot Health

If you have diabetes, here’s a way to keep standing on your own two feet: check them every day—even if they feel fine—and see your doctor if you have a cut or blister that won’t heal.

There’s a lot to manage if you have diabetes: checking your blood sugar, making healthy food, finding time to be active, taking medicines, going to doctor’s appointments. With all that, your feet might be the last thing on your mind. But daily care is one of the best ways to prevent foot complications.

Between 60% and 70% of people with diabetes have diabetic (nerve damage). You can have nerve damage in any part of your body, but nerves in your feet and legs are most often affected. Nerve damage can cause you to lose feeling in your feet.
Feeling No Pain
Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms. Nerve damage can also lower your ability to feel pain, heat, or cold.

Living without pain sounds pretty good, but it comes at a high cost. Pain is the body’s way of telling you something’s wrong so you can take care of yourself. If you don’t feel pain in your feet, you may not notice a cut, blister, sore, or other problem. Small problems can become serious if they aren’t treated early.
Risk Factors
Anyone with diabetes can develop nerve damage, but these factors increase your risk: of foot ulcers.


Diabetes and Your Feet

If you have diabetes, here’s a way to keep standing on your own two feet: check them every day—even if they feel fine—and see your doctor if you have a cut or blister that won’t heal.

Diabetes Type 2

It sounds too good to be true: reversing type 2 diabetes through exercise and healthy eating.

While some times lifestyle changes are key to managing diabetes, whether you can actually turn back time so that it’s like you never had diabetes is a different matter. That depends on how long you’ve had the condition, how severe it is, and your genes.

“Reversal” is used when people can go off medication but still must engage in a lifestyle program in order to stay off.

Getting rid of extra pounds and keeping them off can help you better control your blood sugar.

For some people, reaching a healthier weight will mean taking fewer medications, or in rarer cases, no longer needing those medications at all.

Put your plan in to action

Losing 5% to 10% of your body weight and building up to 150 minutes of exercise a week may help you to slow or stop the progress of type 2 diabetes.

“If you sit [inactive] most of the day, 5 or 10 minutes is going to be great, “Walk to up the stairs when possible. Do things that gets you moving, knowing that you’re looking to move towards 30 minutes most days of the week.”

A study, people with diabetes exercised for 175 minutes a week, limited their calories to 1,200 to 1,800 per day, and got weekly counseling and education on these lifestyle changes.

increased exercise may require comfortable footwear