Orthofeet Footwear Education

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Put Your Best Foot Forward
Foot Care for Adults with Diabetes Presented by
___________________
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Topics

• Everyday Foot Care  Dos and Donts
• Warning Signs Foot Problems
• Neuropathy
• PAD - Poor Circulation
• Annual Foot Exam
• Proper Footwear Therapeutic Shoes

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Diabetes-Related Foot Complications

• Almost 30 of people with diabetes who are 40
  years have lost feeling in their feet and legs
• Diabetes is the leading cause of leg amputations
  not caused by injury or accidents (accounting
  for 60 of amputations)
• In 2006, more than 65,000 nontraumatic lower-limb
  amputations were performed in people with
  diabetes
• People with diabetes are 8 times as likely to
  lose a leg or foot to amputation as people
  without diabetes

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Everyday Foot Care
Everyday Foot Care Checklist Everyday Foot Care Checklist
Check your feet for cuts, cracks, sores, red spots, swelling, infected toenails, splinters, blisters, and calluses
Wash feet in warmNOT HOTwater and dry well
Trim toenails once a week or have someone cut them for you
Rub lotion on tops and bottoms of feetNOT between the toesto prevent cracking and drying
Wear loose fitting socks to bed
Keep your feet warm and dry
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Everyday Footwear
Footwear Checklist Footwear Checklist
Wear comfortable shoes that fit well. Break in new shoes slowly. Have your feet measured
Inspect the inside of shoes for foreign objects and torn lining
Wear stockings or socks to avoid blisters and sores
Wear clean, lightly padded socks seamless socks are best
Always wear shoes or slippers
Ask your doctor about therapeutic shoes
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Foot Care Dos
Foot Care Dos Checklist Foot Care Dos Checklist
Check your feet everyday
Get an annual foot exam
Protect feet from extreme heat and cold
When sitting, keep blood flowing to lower limbs by moving toes and ankles
Control blood sugar, blood pressure, and cholesterol by eating healthy foods, staying active, taking your diabetes medicines
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Foot Care Donts
Foot Care Donts Checklist Foot Care Donts Checklist
Dont walk barefoot, even indoors
Dont cut corns and calluses yourself
Dont use caustic agents or any other irritants for the removal of corns and calluses
Dont wear open-toed shoes, particularly sandals with thongs between the toes
NEVER use heating pads or hot water bottles
Dont smoke
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Smoking and Diabetes

• Smoking is one of the biggest threats to healthy
  feet
• Reduces blood circulation
• Affects blood vessels
• Causes decreased blood flow to feet, making
  wounds heal slowly
• Many adults with Diabetes who need amputations
  are smokers

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Warning Signs

• Foot Problems

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Loss of Feeling - Neuropathy

• Neuropathy is a nerve disorder caused by Diabetes
• More than half (60-70) of people with Diabetes
  have some form of neuropathy
• Can occur in hands, arms, feet, legs and
  throughout organs
• Your feet may tingle, burn, or hurt
• You may not be able to feel touch, heat, or cold
  very well
• You may not have any symptoms

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Deformities
Bunion
Callus from increased pressure
Amputated 3rd toe
Hammertoes
Heel spur or prominent bone
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Fungus

• Toenails may turn thick and yellow. Fungus
  infections can grow between your toes or on the
  top or bottom of your foot.

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Ulcers

• Blisters, sores, ulcers, infected corns, and
  ingrown toenails need to be seen by your doctor
  right away.

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Peripheral Arterial Disease

• P.A.D. Poor circulation
• Extra cholesterol and fat collect in the walls of
  arteries that supply blood to limbs
• P.A.D. affects 8 to 12 million Americans
  especially those over age 50
• One in every 3 people with Diabetes has P.A.D.
• Smokers are 4x more likely to develop P.A.D.
• African Americans are twice as likely

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Signs and Symptoms of P.A.D.
Symptoms Symptoms
Cramping or pain in the legs and/or feet
Sores or wounds on toes, feet or legs that heal slowly, poorly, or not at all
Color changes in the skin of the feet, including paleness or blueness
A lower temperature in one leg compared to the other leg
Poor nail growth and decreased hair growth on toes and legs
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Annual Foot Exam
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Knock Your Socks Off at the Doctors Office

• Take off your socks and shoes at every visit
  even if they dont ask you to do so
• Have your doctor check both feet
• Ask how your feet look and if there are any
  problems

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Annual Foot Exam What to Expect
Exam Checklist Exam Checklist
Look for changes in the shape of feet, toes, nails
Test circulation (pulses in feet, hair growth on your toes and the color and temperature of skin)
Check skin for corns calluses, dryness, cracks, rashes, peeling, blisters or any irritation
Examine structure and function of feet
Test for neuropathy
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Monofilament Test

• The monofilament looks like a long bristle of a
  toothbrush
• It is touched to different places on your foot to
  see whether or not you can feel it
• The monofilament does not hurt
• Keep your eyes closed while being tested so you
  cant see where the doctor is placing the
  monofilament
• Tell the doctor if you feel the monofilament or
  not

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The Tuning Fork

• Used to check for vibration
• The doctor will tap the tuning fork with his/her
  hand, then place it on your toe or foot
• Tell the doctor if you feel a vibration or not
  and when the vibrations stops

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Foot Wear

• Importance of Proper Foot Wear

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Measure Your Feet

• Have your feet measured by a trained health care
  professional
• Heel to toe length
• Heel to ball length
• Width

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If the Shoe Fits
?

• The shape of the shoe must fit the shape of the
  foot

?
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Therapeutic Shoes

• Specially designed for comfort and mobility
• Wide widths
• Increased depth in toe area
• Seamless interiors
• Custom-molded inserts for your feet

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What is the Therapeutic Shoe Bill?

• Medicare Part B covers therapeutic shoes and
  inserts for people with Diabetes who have severe
  diabetic foot disease
• Created as a preventative measure with the goal
  of decreasing amputations directly caused by
  Diabetes complications

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What is Covered and How Often?

• Medicare helps pay for one pair of therapeutic
  shoes and inserts per calendar year
• One pair of custom molded shoes and two pairs of
  inserts per year
• OR
• One pair of depth shoes and up to three pairs of
  inserts per year
• Medicare covers 80 secondary insurance or
  patient covers 20
• Medicare covers the fitting of the shoes or
  inserts for the shoes

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Who Qualifies?

• The doctor who treats your Diabetes must certify
  your need for therapeutic shoes or inserts
• Patient must have diabetes mellitus and one or
  more of the following conditions
• Previous amputation of other foot or part of
  either foot
• History of previous ulceration of either foot
• History of pre-ulcerative calluses
• Peripheral neuropathy with evidence of callus
  formation
• Foot deformity
• Poor circulation in either foot

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Who Can Prescribe Therapeutic Shoes?

• The shoes and inserts must be prescribed by a
  podiatrist or other qualified doctor and fitted
  by one of the following
• Podiatrist
• Orthotist
• Prosthetist
• Pedorthist
• Therapeutic shoe fitter
• Other qualified health care provider

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Amputations Decrease
CDC ANNOUNCES Diabetes-Related Amputations
Decrease 65 in Past 10 Years!
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Designed for Comfort

• Seamless lining
• Breathable mesh fabric
• Ergonomic soles
• Increased room in toe area

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Slip-Ons with Easy Access

• Easy On Off

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Innovative Design Features

• Tie-Less Lacing System

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Custom Molded Shoes

• For Diabetics only
• Shoes molded from a casts of patients feet

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Diabetic Inserts
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Diabetic Shoe Inserts

• For Diabetics only
• Multiple density insert
• Custom molded from model of patients foot
• Arch fill
• Custom fabricated

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Keep Your Feet Comfortable

• Orthofeet has a range of styles

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Happy Feet
Happy Feet Checklist Happy Feet Checklist
Check your feet daily
Remember Dos and Donts of foot care and footwear
Get an annual foot exam
Eat healthy, exercise
Stop smoking
to your doctor to see if you qualify for therapeutic shoes

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Thank you
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References

• http//www.diabetes.org/diabetes-basics/diabetes-s
  tatistics/ retrieved on April 23, 2012
• http//www.cdc.gov/Features/DiabetesFootHealth/Ret
  rieved on April 23, 2012
• http//www.cdc.gov/diabetes/consumer/problems.htm
  10 Retrieved on April 23, 2012
• http//www.diabetes.org/living-with-diabetes/compl
  ications/foot-complications/ Retrieved April 23,
  2012
• http//www.cdc.gov/diabetes/pubs/tcyd/foot.htm
  retrieved April 25, 2012
• http//ndep.nih.gov/media/Feet_broch_Eng.pdf
  retrieved April 25, 2012
• http//www.ihs.gov/MedicalPrograms/Diabetes/HomeDo
  cs/Resources/DiabetesTopics/Treatment/DM_foot_care
  .pdf retrieved April 26, 2012
• Janisse, D presentations on file
• www.medicare.gov retrieved April 29, 2012
• http//care.diabetesjournals.org/content/27/suppl_
  1/s63.fullsec-2, Retrieved April 29, 2012
• http//www.nhlbi.nih.gov/health/public/heart/pad/
• http//www.padcoalition.org/resources/slides.php
  retrieved May 5, 2012
• http//www.diabetes.org/food-and-fitness/fitness/i
  deas-for-exercise/intensity-matters.html
  retrieved May 5, 2012
• https//www.ihs.gov/MedicalPrograms/Diabetes/index
  .cfm?modulefootcare_pt_5 Retrieved on May 5,
  2012