Diabetic & High Risk Foot Management

THE MANAGEMENT OF DIABETIC FEET and HIGH RISK feet often include custom made foot orthotics and accommodative diabetic-friendly footwear in order to reduce the risk of any pressure areas developing. the nature of diabetic and high risk feet often require for patients to pay extra attention to them. As such, the following points are some valuable reminders and protocols that we encourage all of our patients to adhere to in order to ensure that their high risk diabetic feet are safe and that their new foot orthotics and shoes are doing what they have been designed to do – protect their feet and reduce the development of pressure areas.

IMPORTANT PROTOCOLS FOR WEARING IN FOOT ORTHOTICS
The foot orthotics you have been prescribed have been designed to redistribute weight evenly around your foot and to reduce the risk of pressure areas developing. However, given that most diabetic patients have reduced sensation on their feet and subsequently have a high risk of ulcerations; we encourage you to follow these protocols when wearing your new foot orthotics, in order to ensure your feet are safe.

• Wear in the orthotics slowly and gradually – do not wear the orthotics full time for the first few days in order for you to get used to them. We advise that you wear them for 1-2 hours a day for the first few days until you can walk comfortably and safely in them.
• DO NOT go for long walks in the first couple of weeks, as your feet will not be accustomed to the foot orthotics and you will need to adjust to them.
• IF you are required to wear your orthotics full-time as part of your management plan (e.g. post felt management, wound remission), you are advised to check your feet hourly for the first 2-3 days for any signs of pressure areas that may have been caused by your new foot orthotics. Inspect your feet for any unwanted signs of pressure/rubbing that could lead to skin breakdown (e.g., redness, unfamiliar marks, etc.)
• Continue to check your feet regularly each day (3-4 times a day minimum) for any signs of pressure areas that may have been caused by your new foot orthotics.
• Regular reviews are mandatory and are scheduled for the first 2-3 weeks by your orthotist in order to make sure that the foot orthotics are accomplishing their intended aims. Foot orthotics can be fine tuned and adjusted if needed.
• Contact us for an appointment if you encounter any discomfort or pressure issues associated with the foot orthotics.

IMPORTANT PROTOCOLS FOR WEARING IN NEW SHOES
The shoes you have been prescribed are Extra Depth/Width diabetic friendly shoes. They have been designed to provide you with sufficient room to accommodate your orthotics as well as your high risk feet. However, given that most diabetic patients have reduced sensation in their feet, it can be difficult for you or the clinician to tell what is happening within the shoe whilst you are walking in it (regardless of the amount of room within the shoe). Therefore, we suggest the following in order to ensure the shoes are accommodating your feet properly, whilst providing sufficient comfort and safety.

• We advise that you wear in your shoes slowly and gradually.
• We encourage you to check your feet regularly for any rub marks, blisters or sores that could be caused by the shoes or a foreign object (e.g., stones caught within the shoe, seam of your socks).
• Start a routine of checking your feet regularly each day (3-4 times a day minimum) – as we do not want any issues of skin breakdown.
• Inspect the soles of your feet daily. If you are unable to see the bottom of your feet, place a mirror against a wall to see their reflection.
• Check the inside of each shoe with your hand before placing your feet in them.
• Regular reviews are recommended and often scheduled by your orthotist in order to make sure that the shoes are accomplishing their intended aims.
• Contact us for an appointment if you encounter any discomfort or pressure issues associated with the shoes.
• NEVER walk barefoot!

We encourage you to adhere to these protocols in order to ensure that your high risk diabetic feet is safe and that your new foot orthotics and shoes are achieving their intended prescription aims. Non-compliance with these protocols may lead to complications such as ulcerations and the increased risk of amputation.