Diabetic footwear and amputation prevention.

Diabetic footwear and amputation prevention.

By Adam Philps. Senior Podiatrist and Director, Masterton Foot Clinic

Introduction

At Masterton Foot Clinic, around 10-15% of our patients are diabetic. Around 1 in 10 of them end up with foot ulcer or lower limb amputation, a disruptive, if not devastating result for these people.

When designing or prescribing a shoe for a diabetic, the podiatrist considers where the shoe pivots (or rocks) as it will play significant role in the of prevention pressure ulcers.  New research suggests that footwear designed for diabetics, if mass produced, should include a rocker sole element in a standardized location.

Diabetic Shoe Design

When designing a shoe for a diabetic, one of the key elements is deciding where to locate the pivot or rocker point. This is the location at which the shoes pivots forward so that the body can pass over it. If a shoe can pivot smoothly and at the correct location, the pressures under the foot are reduced- thereby reducing the risk of pressure ulcers.

Latest Research

Preece et al (July 2017), recently published a paper which showed that when shoes are designed for diabetics, the  rocking point should at 52% of the shoe sole length . “The apex position at 52% of shoe length was found to minimise peak pressures for the largest proportion of individuals”

Conclusion

For my practice, and our diabetic patients, this piece of research is helpful reinforcing the importance of rocker soles in shoes worn by our diabetic  patients. If pressure under the foot can be reduced to safe levels using well designed footwear, people with diabetes will have much less risk of pressure ulcers and possible amputation.

 

Reference/ More information

https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-017-0208-3

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