Skip to main content
SpringerLink
Log in

Footwear in the Prevention of Diabetic Foot Problems

  • Chapter
The Diabetic Foot

  • 231 Accesses

Abstract

Diabetes represents the primary cause of non-traumatic amputation in the western world (1). It is estimated that approximately 25% of subjects with diabetes will, over the course of their lives, experience problems with their feet and that one-third of these patients will undergo amputation (2–4). Although these data highlight the extent of this problem in the diabetic population, they do not necessarily predicate inevitability: on the contrary, they serve to demonstrate that simple and relatively inexpensive measures may be able to reduce the number of amputations by up to 85% (5–9). Some clinical conditions put the diabetic patient “at risk of ulceration.” An awareness of these conditions and the identification of subjects at risk may permit the introduction of suitable preventive strategies (10–13).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputations in diabetes, in Diabetes in America, 2nd ed. (Harris MI, Cowie CC, Stern MP, et al., eds.), Washington, DC, US Government Printing Office, 1995, pp. 232–238.

    Google Scholar 

  2. Centers for Disease Control. Diabetes Surveillance, 1993. US Department of Health and Human Services, Atlanta, GA, 1993.

    Google Scholar 

  3. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: basis for prevention. Diabetes Care 1990;13:513–521.

    Article  PubMed  CAS  Google Scholar 

  4. Moss SE, Klein BEK. The prevalence and incidence of lower extremity amputation in diabetic population. Arch Intern Med 1992;152:610–616.

    Article  PubMed  CAS  Google Scholar 

  5. Litzelman DK, Slemenda CW, Langefeld CD, et al. Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus. Ann Intern Med 1993;119:36–41.

    PubMed  CAS  Google Scholar 

  6. Edmonds ME, Foster A, Watkins PJ. Can careful foot care in the diabetic patient prevent major amputation? in Limb Salvage and Amputation for Vascular Disease (Greenhalgh RM, Jamieson CW, Nicolaides AN, eds.), WB Saunders, Philadelphia, 1988, pp. 407–417.

    Google Scholar 

  7. Davidson JK, Alogna M, Goldsmith M, Borden J. Assessment of program effectiveness at Grady Memorial Hospital-Atlanta, in Educating Diabetic Patients (Steiner G, Lawrence PA, eds.), Springer, New York, 1981, pp. 329–348.

    Google Scholar 

  8. Runyan JW Jr, Van der Zwaag R, Joiner MB, Miller ST. The Memphis Diabetes Continuing Care Program. Diabetes Care 1980;3:382–386.

    Article  PubMed  Google Scholar 

  9. Assal JP, Muhlhauser I, Pernet A, Gfeller R, Jorgens V, Berger M. Patient education as the basis for diabetes care in clinical practice and research. Diabetologia 1985;28:602–613.

    Article  PubMed  CAS  Google Scholar 

  10. Boulton AJM, Kubrusly DB, Bowker JH, et al. Impaired vibratory perception and diabetic foot ulceration. Diabet Med 1986;3:335–337.

    Article  PubMed  CAS  Google Scholar 

  11. Sims DS Jr, Cavanagh PR, Ulbrecht JS. Risk factors in the diabetic foot. J Am Phys Ther Assoc 1988;68:1887–1902.

    Google Scholar 

  12. Lavery LA, Armstrong DG, Vela SA, Quebedeaux JL, Fleischli J. Practical criteria for screening patients at high risk for diabetic foot ulcerations. Arch Intern Med 1998;158:157–162.

    Article  PubMed  CAS  Google Scholar 

  13. McCabe CJ, Stevenson RC, Dolan AM. Evaluation of a diabetic foot screening and education program. Diabet Med 1998;15:80–84.

    Article  PubMed  CAS  Google Scholar 

  14. Young MJ, Breddly JL, Veves A, Boulton AJM. The prediction of diabetic neuropathic foot ulceration using vibration perception thresholds: a prospective study. Diabetes Care 1994;17:557–560.

    Article  PubMed  CAS  Google Scholar 

  15. McNeely MJ, Boyko EJ, Ahroni JH, et al. The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration. Diabetes Care 1995;18:216–219.

    Article  PubMed  CAS  Google Scholar 

  16. Reiber GE, Vileikyte L, Boyko EJ, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two setting. Diabetes Care 1999;22:157–162.

    Article  PubMed  CAS  Google Scholar 

  17. Harris M, Eastman R, Cowie C. Symptoms of sensory neuropathy in adults with NIDDM in the U.S. population. Diabetes Care 1982;16:1446–1452.

    Article  Google Scholar 

  18. Apelqvist J, Larsson J, Agardh CD. The influence of external precipitating factors and peripheral neuropathy on the development and outcome of diabetic foot ulcers. J Diabetes Complications 1990;4:21–25.

    Article  CAS  Google Scholar 

  19. Litzelman DK, Marriott DJ, Vinicor F. Independent physiological predictors of foot lesions in patients with NIDDM. Diabetes Care 1997;20:1273–1278.

    Article  PubMed  CAS  Google Scholar 

  20. Birke JA, Sims DS. Plantar sensory threshold in ulcerative foot. Lepr Rev 1986;57:216–267.

    Google Scholar 

  21. Sosenko JM, Kato M, Soto R, Bild DE. Comparison of quantitative sensory-threshold measures for their association with foot ulceration in diabetic patients. Diabetes Care 1990;13: 1057–1061.

    Article  PubMed  CAS  Google Scholar 

  22. Kumar S, Fernando DJS, Veves A, et al. Semmes Weinstein monofilaments: a simple, effective and inexpensive screening device for identifyng diabetic patients at risk of foot ulceration. Diabetes Care 1991;13:63–68.

    CAS  Google Scholar 

  23. Rith-Najarian SJ, Stolusky T, Gohdes DM. Identifying diabetic patients at high risk for lowerextremity amputation in a primary health care setting. Diabetes Care 1992;15:1386–1389.

    Article  PubMed  CAS  Google Scholar 

  24. Cavanagh PR, Simoneau GG, Ulbrecht JS. Ulceration, unsteadiness, and uncertainty: the biomechanical consequences of diabetes mellitus. J Biomechanics 1993;26:23–40.

    Article  Google Scholar 

  25. Coughlin MS. Mallet toes, hammer toes, claw toes, and corns: causes and treatments of lesser toe deformities. Postgrad Med 1984;75:191–198.

    PubMed  CAS  Google Scholar 

  26. Habershaw G, Donovan JC. Biomechanical considerations of the diabetic foot, in Management of Diabetic Foot Problems (Kozak GP, Hoar CS, Rowbotham JL, et al., eds.), WB Saunders, Philadelphia, 1984, pp. 32–44.

    Google Scholar 

  27. Ctercteko GC, Dhanendran M, Hutton WC, Lequesne LP. Vertical forces acting on the feet of diabetic patients with neuropathic ulceration. Br J Surg 1981;68:608–614.

    Article  PubMed  CAS  Google Scholar 

  28. Boulton AJM, Betts RP, Franks CI, Ward JD, Duckworth T. The natural history of foot pressure abnormalities in neuropathic diabetic subjects. Diabet Res 1987;5:73–77.

    CAS  Google Scholar 

  29. Gooding GAW, Stess RM, Graf PM. Sonography of the sole of the foot: evidence for loss of foot pad thickness in diabetes and its relationship to ulceration of the foot. Invest Radiol 1986;21:45–48.

    Article  PubMed  CAS  Google Scholar 

  30. Young MJ, Cavanagh PR, Thomas G, et al. The effect of callus removal on dynamic plantar foot pressures in diabetic patients. Diabet Med Suppl 1992;9:55–57.

    Article  CAS  Google Scholar 

  31. Veves A, Murray HJ, Young MJ, Boulton AJM. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia 1992;35:660–663.

    Article  PubMed  CAS  Google Scholar 

  32. Masson EA, Hay EM, Stockley I, et al. Abnormal foot pressures alone may not cause ulceration. Diabet Med 1989;6:426–428.

    Article  PubMed  CAS  Google Scholar 

  33. Lavery LA, Armstrong DG, Vela SA, Quebedeax TL, Fleischli JC. Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med 1998;158:157–162.

    Article  PubMed  CAS  Google Scholar 

  34. Mingardi R, Pasqualetti P, Strazzabosco M, et al. Risk factors for ulceration, amputation, death in a diabetic out-patients clinic. Diabetologia 2000;43(Suppl 1):A243.

    Google Scholar 

  35. Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM. Preventive foot care in people with diabetes. Diabetes Care 1999;21:2161–2177.

    Article  Google Scholar 

  36. Andersen H, Gadeberg PC, Brock B, Jakobsen J. Muscular atrophy in diabetic neuropathy: a stereological magnetic resonance imaging study. Diabetologia 1997;40:1062–1069.

    Article  PubMed  CAS  Google Scholar 

  37. Andersen H, Poulsen PL, Mogensen CE, Jakobsen J. Isokinetic muscle strength in longterm IDDM patients in relation to diabetic complications. Diabetes 1996;45:440–445.

    Article  PubMed  CAS  Google Scholar 

  38. Payne CB. Biomechanics of the foot in diabetes mellitus. Some theoretical considerations. J Am Podiatr Med Assoc 1998;88:285–289 relief of plantar pressure in diabetic patients. Diabet Med 1998;15:518–522.

    Article  Google Scholar 

  39. Delbrid L, Appleberg M, Reeve TS. Factors associated with development of foot lesions in the diabetic. Surgery 1983;93;1:78–82.

    Google Scholar 

  40. Kastenbauer T, Sokol G, Auinger M, Irsigler K. Running shoes for relief of plantar pressure in diabetic patients. Diabet Med 1998;15:518–522.

    Article  PubMed  CAS  Google Scholar 

  41. Ashry HR, Lavery LA, Murdoch DP, Frolich M, Lavery DC. Effectiveness of diabetic insoles to reduce foot pressures. J Foot Ankle Surg 1997;36:268–271.

    Article  PubMed  CAS  Google Scholar 

  42. Mueller MJ. Therapeutic footwear helps protect the diabetic foot. JAm Podiatr Med Assoc 1997;87:360–364.

    CAS  Google Scholar 

  43. Lavery LA, Vela SA, Fleischli JG, Armstrong DG, Lavery DC. Reducing plantar pressure in the neuropathic foot. A comparison of footwear. Diabetes Care 1997;20:1706–1710.

    Article  PubMed  CAS  Google Scholar 

  44. Tovey FI. The manufacture of diabetic footwear. Diabet Med 1984;1:69–71.

    Article  PubMed  CAS  Google Scholar 

  45. Mueller MJ, Strube MJ, Allen BT. Therapeutic footwear can reduce plantar pressure in patients with diabetes and transmetatarsal amputation. Diabetes Care 1997;20:637–641.

    Article  PubMed  CAS  Google Scholar 

  46. Cavanagh PR, Ulbrecht JS, Caput GM. Biomechanical aspects of diabetic foot desease: aetiology, treatment and prevention. Diabet Med 1996;13(Suppl):517–522.

    Google Scholar 

  47. Lord M, Riad H. Pressure redistribution by molded inserts in diabetic footwear: a pilot study. J Rehabil Res Dev 1994;31:214–221.

    PubMed  CAS  Google Scholar 

  48. Mueller MJ. Application of plantar pressure assessment in footwear and insert design. J Orthop Sports Phys Ther 1999;29:745–755.

    Google Scholar 

  49. Foto JG, Birke J. Evaluation of multidensity orthotic materials used in footwear for patients with diabetes. Foot Ankle Int 1998;19:836–841.

    PubMed  CAS  Google Scholar 

  50. Brand PW. Repetitive stress in the development of diabetic foot ulcers, in The Diabetic Foot, 4th ed. (Levin ME, Davidson JK, eds.), Mosby, St. Louis, MO, 1988, pp. 83–90.

    Google Scholar 

  51. Veves A, Murray HJ, Young MJ, Boulton AJM. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia 1992;35:660–663.

    Article  PubMed  CAS  Google Scholar 

  52. Litzelman DK, Marriot DJ, Vinicor F. The role of footwear in the prevention of foot lesion in patients with NIDDH. Diabetes Care 1997;20:156–162.

    Article  PubMed  CAS  Google Scholar 

  53. Uccioli L, Faglia E, Monticone G, et al. Manufactured shoes in the prevention of diabetic foot ulcers. Diabetes Care 1995;18:1376–1378.

    Article  PubMed  CAS  Google Scholar 

  54. Edmonds ME, Blundell MP, Morris ME, et al. Improved survival of the diabetic foot: the role of a specialized foot clinic. Q J Med 1986;60:763–771.

    PubMed  CAS  Google Scholar 

  55. Chantelau E, Haage P. An audit of cushioned diabetic footwear: relation to patient compliance. Diabet Med 1994;11:114–116.

    Article  PubMed  CAS  Google Scholar 

  56. Striesow F. Special manufactured shoes for prevention of recurrent ulcer in diabetic foot syndrome. Med Klin 1998;93:695–700.

    Article  CAS  Google Scholar 

  57. Edmonds ME. Experience in a multidisciplinary diabetic foot clinic, in The Foot in Diabetes: proceedings of the First National Conference on the Diabetic Foot, Malvern, England, May, 1986 (Connor H, Boulton AJM, Ward JD, eds.), John Wiley, Chichester, England, 1987, pp. 121–134.

    Google Scholar 

  58. American Diabetes Association: Consensus Development Conference on Diabetic Foot Wound Care. Diabetes Care 1999;22:1354–1360.

    Article  Google Scholar 

  59. Department of Health and Human Services: Medicare payments for therapeutic shoes. August 1998 OEI-03–97–00300.

    Google Scholar 

  60. Cavanagh PR, Ulbrecht JS. Biomechanical aspects of foot problems in diabetes, in The Foot in Diabetes, 2nd ed. (Boulton AJM, Connor H, Cavanagh PR, eds.), John Wiley, New York, 1994, pp. 25–35.

    Google Scholar 

  61. Stess RM, Jensen SR, Mirmiran R. The role of dynamic plantar pressure in diabetic foot ulcers. Diabetes Care 1997;20:855–858.

    Article  PubMed  CAS  Google Scholar 

  62. Armstrong DG, Lavery LA. Evidence-based options for off-loading diabetic wounds. Clin Podiatr Med Surg 1998;15:95–104.

    PubMed  CAS  Google Scholar 

  63. Caputo GM, Ulbrecht JS, Cavanagh PR. The total contact cast: a method for treating neuropathic diabetic ulcers. Am Fam Physician 1997;55:605–611.

    PubMed  CAS  Google Scholar 

  64. Shaw JE, Hsi WL, Ulbrecht JS, et al. The mechanism of plantar unloading in total contact casts: implications for design and clinical use. Foot Ankle Int 1997;18:809–817.

    PubMed  CAS  Google Scholar 

  65. Borssen B, Lithner F. Plaster casts in the management of advanced ischaemic and neuropathic diabetic foot lesions Diabet Med 1989;6:720–723.

    Article  PubMed  CAS  Google Scholar 

  66. Baumhauer JF, Wervey R, McWilliams J, Harris GF, Shereff MJ. A comparison study of plantar foot pressure in a standardized shoe, total contact cast, and prefabricated pneumatic walking brace. Foot Ankle Int 1997;18:26–33.

    PubMed  CAS  Google Scholar 

  67. Armstrong DG, Todd WF, Lavery LA, Harkless LB, Bushman TR. The natural history of acute Charcot’ s arthropathy in a diabetic foot specialty clinic. Diabet Med 1997;14:357–363.

    Article  PubMed  CAS  Google Scholar 

  68. Armstrong DG, Lavery LA. Elevated peak plantar pressures in patients who have Charcot arthropathy. J Bone Joint Surg [Am] 1998;80:365–369.

    Article  CAS  Google Scholar 

  69. Lavery LA, Armstrong DG, Walker SC. Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy. Diabet Med 1997;14:46–49.

    Article  PubMed  CAS  Google Scholar 

  70. Pinzur MS, Shields NN, Goelitz B, et al. American Orthopaedic Foot and Ankle Society shoe survey of diabetic patients. Foot Ankle Int 1999;20:703–707.

    PubMed  CAS  Google Scholar 

  71. Knowles EA, Boulton AJ. Do people with diabetes wear their prescribed footwear? Diabet Med 1996;13:1064–1068.

    Article  PubMed  CAS  Google Scholar 

  72. Woolridge J, Moreno L. Evaluation of the costs to Medicare of covering therapeutic shoes for diabetic patients. Diabetes Care 1994;17:541–547.

    Article  Google Scholar 

  73. Sugarman JR, Reiber GE, Baumgardner G, Prela CM, Lowery J. Use of the therapeutic footwear benefit among diabetic Medicare beneficiaries in three states, 1995. Diabetes Care 1998;21:777–781.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Luigi Uccioli MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Aristidis Veves MD, DSc , John M. Giurini DPM  & Frank W. LoGerfo MD ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Uccioli, L. (2002). Footwear in the Prevention of Diabetic Foot Problems. In: Veves, A., Giurini, J.M., LoGerfo, F.W. (eds) The Diabetic Foot. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-168-8_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-168-8_22

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-253-7

  • Online ISBN: 978-1-59259-168-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation