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6 Tips on How Your Patients Can Protect Their Diabetic Feet

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Thirty-four million Americans have diabetes. The disease will likely be a lifelong struggle for most of these people. While they may have to deal with it for the rest of their lives, they must remember that managing diabetes (and monitoring their foot health) is possible and encouraged.

Diabetic Foot

Read on to learn what your patients need to know in order to protect their diabetic feet.

Inspect Feet Daily

Your patients need to remember to check their feet every day for any changes that might occur. It’s important to monitor sores on the feet and look for signs of infection. Infections in diabetic people are complicated and prevention is key to staying healthy.

Patients need to look out for red areas, cracked skin or calluses, lesions, or any other changes occurring on the feet, especially between the toes.

Keep Feet Clean and Dry

Your patients need to wash their feet to keep them free of threads and fabrics that can cause friction or irritation. They shouldn’t soak their feet regularly because it can increase dryness.

Once clean, they need to dry their feet, especially between the toes. Diabetic feet are breeding grounds for fungus and bacteria when they aren’t kept dry.

Moisturizing is another task that needs to occur every night giving the feet plenty of time to soak up the cream and smooth out the skin.

Don’t Cut Your Own Toenails

Another common foot-related condition among diabetic patients is they may have thickened toenails, which can be difficult to cut. As a podiatrist, you are better equipped to handle that. By recommending that your patients come to you to get their toenails cut, you will be able to catch potential problems before they become an issue (like ingrown toenails!).

Remind them to leave callus removal to the professionals as well. Removing them with a sharp object can lead to infection while using OTC removers can burn the skin because they are usually made with some type of acid.

Monitor Your Blood Sugar Levels

High glucose can lead to neuropathy which can lead to loss of feeling in the feet. This occurs in approximately 70% of all diabetics. This loss of feeling is dangerous as it can lead to injury, infections, and even amputation.

Your patients can maintain a healthier blood glucose streak by eating well-balanced diets and monitoring blood sugar regularly.

Never Go Barefoot

Loss of feeling in the feet makes it a lot easier to suffer from an injury that causes damage to your patient’s feet. By wearing orthotic slippers or shoes with support, they reduce the chance of getting cuts, bruises, or broken bones when moving around their home. These problems might go undetected by a diabetic due to their awareness becoming hindered by neuropathy or loss of feeling in their feet.

Wear the Right Socks and Shoes

Wearing the right socks and shoes is essential for diabetics, especially those dealing with numbness.

There are certain types of shoes for diabetic feet that are made to prevent friction and irritation. They are generally soft, padded, and seamless. These shoes are deep enough for diabetic inserts and orthotics to be placed inside the shoe for maximum comfort.

Check our website for a list of diabetic shoes we have in stock.

The ideal socks for diabetics are going to be made out of fabric that is moisture-wicking such as natural wool or bamboo. They are going to fit snugly on the feet and legs without adding extra pressure on the skin. Ideally, you should have your patients look for socks with copper-infused yarn as well as moisture-wicking properties for added protection and anti-fungal benefits. Check out our line of Diabetic Copper Cloud Socks on our website.

Caring for Diabetic Feet

Caring for diabetic feet isn’t easy, but it will make a world of difference in a diabetic’s overall health and well-being. It’s important that, as their medical clinician, you are relaying essential information to your patients to help them maintain healthy feet.

Contact SafeStep today for more information on our patient evaluation processes and how our products promote diabetic foot care.

Understanding the Difference Between Diabetic and Regular Footwear

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Diabetic Footwear helps prevent the continued wear of the feet and helps to decelerate the breakdown of the plantar fascia. You may be wondering, what is diabetic footwear?

This article will help you understand what diabetic footwear is and how it differs from regular footwear.

What is Diabetic Footwear? 

Diabetes causes various health and physical ailments to those who suffer from it. One of the primary side effects of diabetes is moderate to severe nerve damage.

Diabetics often experience and suffer from nerve damage to their feet. This causes them to lose feeling as well as lose blood flow to their feet.

neuropathy

This condition is known as peripheral or diabetic neuropathy. This condition starts relatively mild at first but can progressively get worse. This could later develop into ulcers and varicose veins.

To prevent these things from occurring, Diabetics must take preventative action by extra good care of their feet. This begins with proper diabetic socks and special orthopedic footwear.

How Does it Differ From Regular Footwear?

Diabetic footwear is specially designed to assist with blood flow to the feet. It also helps protect the foot against injuries to the toes and the bottom of the foot.

Diabetic footwear is often paired with specialized orthotic inserts to protect against sores and provide arch support, heel support, and metatarsal support where needed.

Normal shoes do not protect against sores and damage to the extremities. The best diabetic footwear provides both protection and support. Normal footwear only provides minimal protection from the elements and is a device used to separate the foot from the ground.

You can increase protection and comfort by prescribing and recommending diabetic inserts and diabetic shoes for your patients.

What Shoes Are Best For Diabetics? 

Diabetic shoes should not be bulky or restrictive. Diabetics need to have plenty of room for their feet to move and breathe, including a high and wide toe box, as well as adjustable closure options to accommodate edema.

The best shoes are lightweight and have superior stability. They should have substantial midsole/outsoles to protect your patients’ feet from the uneven surfaces they walk on, and ideally be slip-resistant, too.

Selecting Your Diabetic Footwear

There are generally two categories of diabetic shoes. These include walking shoes and casual shoes.

Walking shoes resemble an athletic sneaker, and should have a high and wide toe box, be available in multiple widths, and have removable spacers or depth to accommodate inserts and provide a superior fit. They should also have a very rigid sole and a reinforced heel counter.

Casual shoes may resemble shoes like men’s or women’s dress styles, boat shoes, or casual or closed-toe sandals. When selecting a casual shoe, you will want to look for many of the features listed for the walking style and look for a footwear provider that specializes in diabetic or orthopedic footwear, such as SafeStep.

The best shoes for diabetic patients should have breathable uppers, and superior motion control and support. Support is not a common feature in most shoes, therefore it is paramount that you look for specific orthopedic/therapeutic footwear brands.

As a general rule of thumb, Diabetics should avoid high-heeled shoes, most sandals, and open-toed shoes as most of these styles do not provide proper support and may restrict blood flow and edema.

Get Your Diabetic Footwear Today

diabetic footwear

Diabetic footwear is an essential part of every diabetic’s preventative care routine. Foot care helps prevent serious issues that can lead to serious health conditions including surgery or amputation.

Fortunately, our staff at SafeStep has a variety of footwear options for your needs. We have an extensive catalog available on our website.  Contact us today with any questions or concerns you may have.

Diabetic Socks: Everything You Need to Know

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Every 1 in 10 people is suffering from diabetes. This means every person with this health condition needs to worry about what they eat, drink, and most importantly what they wear on their feet.

It can be easy for Diabetic patients to overlook the importance of footwear, but we need to remind them that it should be a daily priority.
Before the footwear comes socks, diabetic patients need to know what types of socks they should and should not be wearing.

This article will give you all the answers to the question, “What are diabetic socks?” and points you in the right direction for diabetic footwear so you can pass on the information to your patients.

What Are Diabetic Socks?

Copper Cloud Socks

First, let’s cover the basics…

Diabetic socks are specially designed to reduce one’s risk of a foot injury, improve blood circulation, help prevent bacteria formation and make sure the feet stay dry. Diabetic Socks could be a life-changing addition to your patients’ lives.

But, how do they differ from regular socks?

1. Circulation

It is common for people suffering from diabetes to have problems with their feet that can lead to swelling and loss of nerve damage. The scientific name for this is neuropathy.

By removing the elastic that puts pressure on your feet from regular socks, diabetic socks allow blood to flow and help prevent the risks associated with socks that do not accommodate edema.

2. Rubbing

Diabetic patients are at higher risk of having foot complications like sores, open wounds, and blisters. Socks with too much compression or that are too tight will cause rubbing and exacerbate these issues.

Diabetic socks ease the tension and provide a more comfortable fit so you don’t have to experience the constant rubbing that is associated with normal socks.

Additionally, diabetic socks may be infused with Copper yarn, which has natural antimicrobial, anti-fungal, and anti-odor properties that help keep the feet in a clean environment and leaves skin softer.

3. Sweat Reduction

It is also important for patients to keep their feet dry. Why? Because sweat that festers for too long can cause infections and sores.

The best diabetic socks keep your feet dry and cozy. The ideal combination. Most diabetic socks have moisture-wicking properties that help keep the feet dry. Additionally, some socks may be specifically ventilated to promote temperature control and airflow.

It’s important to provide your patients with everything they need to manage their condition and get the best out of their daily lives. Helping prevent feet issues with the proper diabetic socks is a great start.

Other Ways to Support Diabetic Feet

You can never have too much foot support. Make sure you pair diabetic socks with proper diabetic footwear for your patients.

Here is a list of features you will want to look for when recommending diabetic footwear to your patients:

  • Protective interior lining
  • Stretchable uppers
  • Firm Heel Counter
  • Stable midsole/outsole
  • Extra-depth to accommodate orthotic inserts
  • High and wide toe box
  • Adaptable closure

Copper Cloud Socks

The next time your patient asks about ways to support their feet you can suggest diabetic socks, diabetic footwear, as well as supportive inserts. You can find all of your diabetic footwear needs by visiting the SafeStep website!

Medicare DME Reimbursement Increases in 2022

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2022 Updated reimbursements:

Depth Shoes (A5500): pair $186.72 (Ceiling)
Prefabricated, Heat Molded Inserts (A5512): pair $76.16 (Ceiling)
Custom Milled Inserts (A5514): pair $113.64 (Ceiling)
Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $415.20 (Ceiling)
Depth Shoes w/3 pr. Custom Milled Inserts: $527.64 (Ceiling)
Custom Molded Shoes (A5501): $560.00 (Ceiling)
Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1281.17, Floor $960.88
Arizona Balance Brace (L1940, L2330, L2820): pair – Ceiling $2562.34, Floor $1921.76

Medicare DME Reimbursement Increases in 2020

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Good news!

On January 1, 2020, Medicare increased the amount it pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs.

While the amounts paid may vary slightly by state, the National Fee Schedule is as follows:

Depth Shoes (A5500): pair $147.74
Prefabricated, Heat Molded Inserts (A5512): pair $60.26
Custom Milled Inserts (A5514): pair $89.92

Depth Shoes w/3 pr. Prefab, Heat Molded Inserts: $328.52
Depth Shoes w/3 pr. Custom Molded Inserts: $417.50

Custom Molded Shoes w/offset heels and rocker bottoms: $585.26

Arizona AFO, Standard (L1940, L2330, L2820): each – Ceiling $1216.57, Floor $912.42
Moore Balance Brace (L1940, L2330, L2820): pair – Ceiling $2433.14, Floor $1824.84

For a complete listing of updated DME allowables, including prefabricated and custom ankle-foot orthoses, visit:

https://www.cms.gov/medicaremedicare-fee-service-paymentdmeposfeescheddmepos-fee-schedule/dme20a

Essentials For Diabetic Shoe Fitting Success By Josh White, DPM, CPed

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I recently visited a team a podiatrist’s office. They have been a part of the Therapeutic Shoe Program and fitting diabetic patients with shoes for many years. I appreciated their interested in learning how they could improve what could be considered a “good” shoe program, and in going from “good” to “better” or even “great.”

All staff members were encouraged to attend, including: the front office person, who is the eyes and ears of the practice, and who reminds the doctors which patients have diabetes and are due for an annual comprehensive diabetic foot exam (CDFE); the fitting person, who measures, fits and laces patients’ shoes – critical to the program’s success.

We reviewed how the Medicare Therapeutic Shoe Program provides win – win – win benefits for all: patients benefit by getting shoes they need for little or no cost, by doing so, they also decrease their risk for ulceration and amputation, and the office makes money while improving patient satisfaction (and Medicare actually reduces costs).

We reiterated the importance of clearly defining each step in the evaluation and shoe fitting process, and confirmed that while there could be more than one person performing each task, there must be a single person responsible for its execution.

And lastly, we defined the metrics for determining the success of each step – as well as for the program overall.

Here are the steps and how to determine successful execution:

  • Determine the number of patients in the practice with Medicare and diabetes. Every patient should have a dedicated visit for an annual comprehensive diabetic foot evaluation (CDFE) scheduled on a separate visit. This visit can performed by or overseen by the DPM and billed as 99213 if a predisposing condition of ulcerative risk is determined and a plan of care prescribed. Printed copies of the CDFE form are available, for free, from SafeStep upon request. Here is a link to the form: http://safestep.net/safestep/PDF/CDFE(Interactive).pdf?id=431. Note: Someone should track the number of CDFE exams performed (on an ongoing basis), and compare it to the number of patients with diabetes in the practice.
  •  Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be prescribed therapeutic shoes. When scheduling patients, either have a shoe fitting person in the practice available to assist on that day or consider OHI’s Central Casting Program, an on-site Pedorthic service availing Certified Pedorthist to assist podiatrists with examining, casting and fitting patients.
  • Every shoe fitter and CPed should use the “4S’s approach to shoe fitting” which are: Size, Shape, Stability, Style to fit and pair the shoes that meet each patients’ aesthetic desires and therapeutic needs. It’s important to have shoe samples in the styles patients most prefer, and to update them periodically. Fitting displays or a small fitting inventory will go a long way to improve fitting success and patient satisfaction. Patients whose fitting needs exceed what’s possible with depth shoes should either be casted for custom molded shoes or referred to a local footwear clinic. The SafeStep website displays the practice’s “Fit Rate”. If not 85% or better, help is available to fit at least as well as is done by the average office.
  • Use SafeStep’s WorryFree DME program to create Medicare compliance documentation and to procure required authorization from the certifying MD physician. SafeStep’s team of professionals and dedicated services help you save time, and build your practice.
  • When dispensing shoes, emphasize to patients the importance of daily footcare and self-examination to check for signs of ulceration. Encourage them to wear their fitted shoes and inserts as a preventative measure, and to return on an annual basis to be re-evaluated for replacement shoes each year.
  • The true indicators of a successful diabetic shoe program is when the number of shoes fitted increases each year, and the number of wounds treated decreases. While some practices have been deterred from fitting shoes because of the effort required and concerns about Medicare audits, many enjoy the success that this preventative care indicative was intended to achieve. Read the article “Keys for Success for Fitting Diabetic Shoes” to learn more.
  • Qualifying patients should be scheduled for an evaluation and fitted with shoes annually. Despite the benefits, most practices refit less than 25% of patients from one year to the next when all it takes is an outreach effort to patients from each year. Your SafeStep homepage displays the practice “Repeat Rate”. There are tools available, including patient lists, which can be used to facilitate a recall program, to ensure that every patient is evaluated annually to be refit with replacement shoes. To better understand the true value to your practice, read “The $40,000, 4 Hour per Week Diabetic Shoe Program”. The article describes how little time is actually needed, if the program is organized effectively, to yield significant benefits to patients and to the practice.
  • Successful practices set goals at the beginning of each year and monitor their performance on an ongoing basis. To recap, key metrics for ensuring program success include:
    1. The number of annual CDFE’s performed on patients with Medicare. Compare to the number of patients with Medicare and diabetes in the practice. Every patient should have at least one annual evaluation.
    2. The number of shoe fit, covered by Medicare. Conservatively, 75% of patients with Medicare and diabetes will have a qualifying risk factor and should be fit with shoes.
    3. Shoe fit rate. Should be 85% or better. Track on SafeStep Members Home Page. If lower than it should be, assistance is available to help improve.
    4. Refit Rate: Should be 75% by end of year.

Successful practices create incentive programs to reward staff members responsible for each of these key metrics.

  • Further assistance is available by scheduling a One-on-One Training Session with a SafeStep DME Specialist. Topics include:
  • “The WorryFree DME Shoe Ordering Process”
  • Diagnosis Specific DME Treatment Protocols for AFOs
  • AFO and Shoe Compliance Documentation
  • 18 Surefire Ways to Improve Your Shoe Fitting
  • Fall Risk Management Made Easy with Moore Balance
  • The CDFE Strategy

I hope you find this article helpful. I truly enjoy writing these articles and working with practices to help them become more successful. Our friendly SafeStep customer service team is available to assist you with your account and all programs, products, services.

Extra-depth Shoes May Help Alleviate Foot Pain for Older People

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For adults over age 65 with disabling foot pain, being fitted for off-the-shelf extra-depth footwear reduced pain and improved function, according to a new study.

This type of footwear is often marketed to people with diabetic foot ailments, for whom Medicare – the U.S. government health insurance program for people over 65 – will cover most of the cost of the shoes.

Click here to read the full article!

New Patient Brochure Helps Ensure That Patients With Diabetes Get Evaluated For Annual Shoe Fitting

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More than 75% of patients with diabetes and Medicare fit with shoes one year are not fit the next.  This, despite annual coverage that offers podiatrists very reasonable reimbursement and that the American Diabetes Association recommends that patients be evaluated annually to determine their level of ulcerative risk.

SafeStep has created a brochure for podiatrists to give to patients with Medicare and diabetes when scheduling an annual Comprehensive Diabetic Foot Exam.  The brochure explains to patients the importance of the exam as well as qualifications for shoes under the Therapeutic Shoe Program.

IMAGE1

IMAGE2The brochure is available personalized with your practice name and address.  Use as both an appointment reminder for patients’ CDFE and to explain to patients its importance.  It includes at-home foot care tips.  It also shows a preview of stylish athletic, dress or casual Medicare-covered diabetic shoes.

Call 866.712.STEP (7837) to order free sample brochures.  Also schedule a FREE Training Session with a SafeStep EXPERT to learn how to ensure that patients with diabetes, fit with shoes are, if qualified, fit year after year.  Let us show you how to ensure that patients in need of care get it and also that your practice does not miss out on revenue opportunities.

At the conclusion of your training session, your SafeStep EXPERT will ensure that you:

  • Determine your “Number”, the number of patients in your practice with Medicare and diabetes.
  • Can track your practice shoe fitting success using the SafeStep Practice Report Card

SafeStep DME Training will help you grow your practice, improve patient care and enhance practice revenue.

 

Shoe Orthoses Reduced Diabetes-Related Amputations

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Long-term use of shoe orthoses significantly reduced diabetes-related amputations, according to study results recently presented at the International Society for Prosthetics and Orthotics World Congress in Hyderabad, India.

Researchers studied 114 Swedish patients with diabetes and a risk of developing foot ulcers. Over 2 years, patients wore one of three different types of shoe orthoses.

Results showed that the use of orthoses, podiatry, education and regular check-ups helped patients avoid foot ulcers. Overall, only 0.9% of participants developed new foot ulcers during the first year vs. an industry average of 3% to 8% reported in similar diabetic populations.

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Good Ulcer Management Reduces Amputation Caused by Diabetes

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Amputations caused by diabetic complications can be reduced by at least 50%with the use of proper shoe inserts, podiatry care and regular health checkups, according to a study that will be presented at the International Society for Prosthetics and Orthotics World Congress in Hyderabad, India from Feb. 4-7.

The study, conducted by researchers at the University of Gothenburg’s Sahlgrenska Academy in Gothenburg, Sweden, included 114 patients with diabetes who were at risk for developing ulcers. Each participant wore one of three shoe insoles and was monitored over a 2-year period. The researchers found that only 0 cialis pas cher france.9% of the participants developed a new ulcer during the first year.

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