Diabetes and Foot Health – Part 1 Medicare/Medicaid Diabetic Shoe Program

By Burton J. Katzen, DPM

Metro Foot Care Centers

. http://www.marylandfootdoctor.com

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Diabetes and Foot Health – Part 1 Medicare/Medicaid Diabetic Shoe Program

Many people with diabetes have mild to severe forms of decreased circulation and nerve damage (peripheral neuropathy). These two conditions can combine to form a lethal combination because simple cuts, scratches, and breaks in the skin can occur without you feeling them and invite infection because of the lack of circulation to bring infection-fighting cells to those tissues that need them.
Many common pressure producing foot problems such as blisters,
corns, calluses, warts, fissures, athletes foot, ingrown nails and incorrect nail trimming can become limb and even life threatening if left untreated in a diabetic.

Burning, tingling, or painful feet.
Loss of sensation in the feet
Change in shape of the feet
Hair loss on toes
Dry and cracked feet
Thick and yellow toenails
Toe fungus or infections
Blisters, sores, ulcers, ingrown toenails, or infected corns that are slow to heal
Changes in the color or temperature of the skin on your feet
Pain or swelling of the foot or ankle
Pressure points such as corns, calluses or bunions

The key to preventing foot problems in a diabetic is keeping you blood sugar level under control and taking good care of your feet every day. Regular visits to a podiatrist are important so the health of your feet can be closely monitored. Also, there are many things you can do at home to avoid diabetic foot complications. These include
Inspect your feet each day for any breaks in the skin or redness. This includes the bottom of your feet and between your toes
Do not use chemical corn or callous remover. These contain acid which might cause severe chemical burns in a diabetic
Never use heating pads or hot soaks on your lower extremities
Never cut corns, calluses, or ingrown nails
Avoid constriction to the lower extremity, such as crossing your legs, tight garters, girdles or socks
Stop smoking
Avoid weight gain and stay active with a medically approved exercise program
Make sure your shoes are properly fitted and your socks are clean. Any imperfections within the shoe, such as seams, tears, or nail and staple protrusions around the heel can lead to irritation and problems.
Wash and dry your feet and between your toes each day with soap and lukewarm (never hot) water. Check with your podiatrist before using a home whirlpool and never have the water temperature above 90 F. Never test bath or whirlpool water with your feet.
You may want to buy a fish tank thermometer.
Never ignore minor foot problems or irritations. Delay in seeking professional treatment may lead to a disastrous outcome.
Apply moisturizing cream to your feet, but never between your toes.

There are certain times of year (usually around October through March) where there is very little moisture in the air. This can mean dry cracked skin, and for a diabetic it can lead to infections and other serious complications. Therefore, it is very important for a diabetic to keep the hands and feet moisturized.
Normally when applying cream to your skin, over 99% evaporates or goes into your sock or bed sheet. To achieve maximum skin absorption and effectiveness perform the following steps
Moisten your foot (bath, shower, lukewarm foot soak) to open the pores of your skin.
Apply cream to feet, but not between your toes. (Unless otherwise instructed, you may use any moisturizing cream such as Vitamin A, Vaseline, or even Crisco).
Apply plastic bag around your foot and ankle (You may use the plastic bag that comes with the newspaper, a regular baggie, or saran wrap. For your hands, you may use rubber gloves).
Apply sock over plastic bag and leave on for 1-2 hours depending on your tolerance.
Remove sock and plastic bag and wipe foot with dry towel.
If you have any skin condition other than simple dry skin, you will be instructed which cream to use.

If you are a diabetic with Medicare/Medicaid secondary insurance, you can receive at minimal cost to you a pair of comfortable supportive shoes designed to prevent blisters, corns, calluses, ulcers and other kinds of sores that occur with the diabetic foot. You are entitled to one pair of shoes and three pairs of customized inserts every year. This is a program initiated by Medicare to help prevent diabetic complications that may be limb threatening before they occur. There are a wide variety of style and color choices.
We will do all the paperwork and fittings, and your satisfaction is guaranteed. Call the office or see the receptionist for details.