Diabetic Foot

What is a Pedorthist?

Canadian Certified Pedorthists are healthcare professionals trained in the assessment of lower limb anatomy and biomechanics. They specialize in the design, manufacture and fit of orthotics, footwear and braces for the knee, lower leg, ankle and foot. This is important when assessing a diabetic foot. Their goal is to help you recover and gain full mobility.

Diabetic Foot Care

For people living with diabetes, fluctuations in blood sugar levels can among other things, impair the body’s vascular (blood flow) and nervous (sensation) systems. Over time, high blood sugar levels can lead to damage of these blood vessels (also known as peripheral arterial disease – PAD) and some of the nerves in the body (also known as peripheral neuropathy – DPN). With loss of sensation in the feet, early warning signs of shoe pressures, rubbing or even having a foreign item in the shoe can be an issue. In a short time breakdown of the skin may occur and Diabetes can make these injuries more difficult to heal. Unnoticed and untreated, even small foot injuries can quickly become infected, potentially leading to serious complications. Booking an appointment with a Pedorthist at OKAPED for an assessment can help you to identify potential problems and help you make healthy choices for your feet.

Pedorthic Care

Care for you feet begins with what you put on them. At our initial exam we will screen for shoe fitting and sizing errors as well as proper sock selection and education. Our biomechanical exam and gait analysis will specifically identify bony and alignment features as well as your walking characteristics that may increase your foot related risks.

Socks should be seamless, and fit constriction free in their entire length. Breathability and moisture wicking can help to reduce breeding of infection-causing bacteria. Specific diabetic socks help reduce foot and leg swelling by increasing blood flow.

Shoe features may include:

Minimal seams throughout the shoe to reduce potential friction sites.
Deep and wide toe boxes to reduce the chance of pressure points
Insoles should be removable and not have increased support as they may increase pressure
Outer soles should be cushioned but resist rapid collapse or compaction
Laces are ideal so fit adjustment can be altered. Velcro closures can be used if lace tying is difficult. Avoid slip on footwear.

OKAPED Custom Foot Orthotics for Diabetes

Orthotics are made from a 3D mold of the feet or via direct molding with Plastazote. Plastazote is considered a gold standard material for wound care. It specifically helps with the reduction of friction, pressure and accommodation of foot shape anomalies.

Materials selected for OKAPED custom foot orthotics help create more uniform pressure distribution while still offering proper support when biomechanical control of the feet is required.

Most custom Orthotics for people with diabetes will be made from soft raw materials and offer full contact along the entire foot length.

Diabetic Daily Foot Care

Helpful Tips from the Canadian Diabetes Association

As always, prevention is the best medicine. A good daily foot care routine will help keep your feet healthy.

Start by assembling a foot care kit containing nail clippers, nail file, lotion, and a non-breakable hand mirror. Having everything you need in one place makes it easier to follow this foot care routine every day:

Wash your feet in warm (not hot) water, using a mild soap. Don’t soak your feet, as this can dry your skin.
Dry your feet carefully, especially between your toes.
Thoroughly check your feet and between your toes to make sure there are no cuts, cracks, ingrown toenails, blisters, etc.
Use a hand mirror to see the bottom of your feet, or ask someone else to check them for you.
Clean cuts or scratches with mild soap and water, and cover with a dry dressing suitable for sensitive skin.
Trim your toenails straight across and file any sharp edges. Don’t cut the nails too short.
Apply a good lotion to your heels and soles. Wipe off excess lotion that is not absorbed. Don’t put lotion between your toes, as the excessive moisture can promote infection.

Wear fresh clean socks and well-fitting shoes every day. Whenever possible, wear white socks – if you have a cut or sore, the drainage will be easy to see.

Best Advice

Do:

Wear well-fitting shoes. They should be supportive, have low heels (less than five centimeters high) and should not rub or pinch. Shop at a reputable store with knowledgeable staff who can professionally fit your shoes.
Buy shoes in the late afternoon (since your feet swell slightly by then).
Wear socks at night if your feet get cold.
Elevate your feet when you are sitting.
Wiggle your toes and move your ankles around for a few minutes several times a day to improve blood flow in your feet and legs.
Exercise regularly to improve circulation.
Inspect your feet daily and in particular, feel for skin temperature differences between your feet.

Don’t:

Use over-the-counter medications to treat corns and warts. They are dangerous for people with diabetes.
Wear anything tight around your legs, such as tight socks or knee-highs.
Ever go barefoot, even indoors. Consider buying a pair of well-fitting shoes that are just for indoors.
Put hot water bottles or heating pads on your feet.
Sit or cross your legs for long periods of time.
Smoke. Smoking decreases circulation and healing, and significantly increases the risks of amputation.
Wear over-the-counter insoles – they can cause blisters if they are not right for your feet.

For more information about diabetes and for diabetes related health resources visit https://www.diabetes.ca/