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Diabetic Orthopedics

The Hanger National Orthotics Program was developed to provide enhanced levels of care that promotes the highest levels of independence and function for patients of all ages and abilities. With nearly 26 million people affected by diabetes our orthotic and pedorthic team is committed to serving our patients by offering and a custom foot orthotics, specialty shoewear and our Diabetic Foot Care Program.

Staying at the orthotic forefront requires a commitment to the advanced training of its clinical team. Hanger maintains the industry’s highest educational standards. Advanced training sessions are regularly held on a variety of orthotic specializations. Upon completion of these intensive courses, Hanger practitioners are designated as Orthotic Specialists. Through a national network of local specialists, Hanger can provide new techniques and clinical offerings within communities throughout the United States. Patient education is a key component. Patients are apprised of the proper use of their orthosis(es) and provided with an explanation of their orthotic system.

Diabetic Orthotic Treatment Program

Together with your physician, your orthotist/pedorthist will design an orthotic program to best meet your needs. This may include any of the following: extra-depth or custom shoes, custom insoles, healing shoes, shoe modifications, and/or a variety of ankle-foot orthoses. Each procedure will be outlined and explained thoroughly to you.

Diabetic Custom Footwear

People with diabetes and particularly diabetic neuropathy, need to pay special attention to the style and fit of the shoes they wear. The shoes and inserts provided by Hanger Prosthetics & Orthotics are made from breathable materials and are designed to cushion while providing extra support to the ankle, arch and heel. By evenly distributing body weight across the foot, these shoes help prevent painful pressure points, blisters and sores from developing. The extra depth shoe design allows room for special foot orthoses.

Diabetic Foot Care Program

The diabetic foot care program is a comprehensive approach to maintaining the health of your feet. Diabetes affects approximately 26 million people in the United States, and a very large percentage of these patients experience problems with their feet. Knowledgeable and consistent care can avoid potential problems which may lead to amputation.

People with diabetes often experience medical issues with their feet and legs. The associated neuropathy, loss of sensation, and poor vision present significant challenges to proper care. Your continued walking abilities and quality of life depend upon close inspection, proper shoewear, a few specific do’s and don’ts, and a commitment with your medical care team.

Diabetic Foot Care Follow-Up Program

The application of the diabetic foot care program is part of an integrated rehabilitation process--and you are the most important team member! The relationship with your orthotist/pedorthist is a lifelong commitment to your health, walking ability, independence and overall quality of life.

Personal Hygiene and Skin Care

Practice good hygiene habits by cleansing and inspecting your feet and
wearing clean socks each day.

Orthoses: Diabetic insoles and arch supports MUST be custom made and fully contoured to the plantar surface of your foot.

Know Your Feet: Daily inspection is required. Look for blisters, sores,
cracks, cuts, calluses, corns, etc. Look at the top, bottom and sides with
a mirror. Report any changes to your physician or orthotist/pedorthist
immediately.

Cleaning and Softening: Wash daily with mild soap and lukewarm water.
Dry thoroughly. Apply cream or lotion on tops and bottoms only, not between
toes. Wear clean socks each day.

Toenail Care: It is best to trim right after your shower or bath. If you have
a neuropathy, poor vision and/or extremely thick toenails—STOP—and enlist
the care of a podiatrist!

Over-the-Counter Remedies: DO NOT use corn or wart removers. DO NOT remove corn or calluses with a razor blade. DO NOT warm up cold feet with a heating pad or hot water bottle. ALWAYS check with your doctor first.

Footwear: NEVER walk barefoot and ALWAYS wear shoes and socks.
Examine shoes for signs of wear. Wear the proper footwear—your long-term
health and mobility is more important than fashion.

DO
DO watch your blood sugar!
DO eat nutritious foods!
DO inspect your feet daily!
DO participate in an exercise program!
DO communicate!

DON’T
DON’T smoke!
DON’T drink excessive alcohol!
DON’T sit or lay with crossed legs or ankles!
DON’T wear sandals with thongs!
DON’T use adhesive tape!
DON’T soak your feet!

How Does Diabetes Affect My Foot?

Diabetes will affect your foot in three ways. How you care for your Diabetes and manage your sugars will impact how soon these changes occur and the severity of the impact.

• If you sugar levels are always high, you may notice changes as soon as 10 years from your diagnosis.

• If you sugar levels are kept under control, these changes will occur very slowly.

The Three Changes:

1. Diabetes makes your nerves in your feet fall asleep. Nerves supply the tiny muscles inside your feet. When the nerves fall asleep, the foot muscles become weak. The nerves become weak and do not work, which can make your feet numb and you will not be able to feel the bottom of your feet. Your feet can change shape and develop curled or crooked toes, bony bumps, flatter feet or wider feet, and calluses. Nerves also supply the sweat glands to your feet. If the nerves fall asleep, your feet do not sweat and you get dry feet.

2. Blood flow to your feet decreases. Diabetes decreases the amount of blood that flows to your feet. Blood brings food and oxygen to the feet. It also brings medicines to your feet. If you are taking medication for an infection, the full dose of the medicine may not reach your feet. If your blood flow is weakened, your skin can become thinner. This can cause you to get cuts or sore more readily. The decreased blood flow also slows down the healing process, which can cause long-term infections.

3. Infections are harder to cure. Diabetes weakens your immune system and your ability to fight an infection. A small cut, scratch or sore on your foot may lead to an infection. Once you get an infection, it is harder to cure and may lead to an amputation.