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Protecting the Diabetic Feet with Diabetic Shoes

In 2020 it was estimated that over 34 million people in the United States have diabetes, roughly 10% of the US population and that 88 million people over the age of 18 have prediabetes. Very concerning as Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation. 

According to a NCBI Lower Extremity Amputation Study in 2020, “…patients with Diabetes Mellitus have an astounding 30 times greater lifetime risk of undergoing an amputation when compared to patients without diabetes mellitus, which translates to an economic strain in healthcare systems of over $4.3 billion in annual costs in the USA alone.” The risks are high for diabetic patients, and it is crucial that the medical community continues to raise awareness to diagnose and treat diabetics with medication, lifestyle changes and proper footcare.

Diabetic Shoes offer protection for the diabetic foot and can help reduce the risk of lower extremity complications. They help prevent ulcers and calluses from forming, distribute weight away from pressure points and accommodate foot deformities.  In addition to the precise measuring and fitting exams each patient receives, diabetic shoes have the following special features:

·        Extra depth to accommodate diabetic inserts

·        Protective interiors with seamless stitching to prevent skin irritations

·        Roomy toe boxes to protect toes and prevent injury

·        Non-skid soles and rocker bottoms for stability and to prevent falls

·        Thick, padded tongues and heel collars for extra comfort and to prevent heel slippage

·        Constructed with qualify materials such as soft leather, mesh, and lycra for breathability and to accommodate patients with swelling or deformities.

·        Multiple shoe widths to accommodate each patient 

In 2017 for the very first time, the American Diabetes Association Standards of Medical Care in Diabetes began recommending the use of diabetic shoes in its footcare recommendation. This year’s Journal states, “The use of specialized therapeutic footwear is recommended for high-risk patient with diabetes including those with sever neuropathy, foot deformities, ulcers, callous formation, poor peripheral circulation or history of amputation.”

Podiatry is the only profession that Medicare has permitted to perform the clinical foot exam, order the diabetic shoes, and dispense them to their patients. On average, over 80% of diabetics in any given podiatry practice qualify for diabetic shoes and inserts.  

The value of providing them every year to help reduce their risk of lower extremity complications should not be underestimated.

Tips for Dispensing Diabetic Shoes the Easy Way!

Every diabetic patient who has at least one of the six qualifying foot conditions per the LCD, is eligible for Diabetic Shoes and Inserts. Up to 80% of a podiatry practice’s patients may qualify! Read on for some helpful tips to keep your Diabetic Shoe Program running smoothly.

Keep diabetic shoe catalogs updated! We update our catalogs in our newsletters and provide QR codes so you can view the latest online version which includes any new styles added. You can call also call Dia-Foot at (877)405-3668 prompt 2 for a list of current updates. Crossing off discontinued shoes in your office catalogs can help speed up your orders.

During your patient’s foot exam, measure accurately with a Brannock device and document the required elements - the qualifying foot condition, what you are ordering, the foot measurements and if ordering custom inserts, add casting details and justification.

Patient communication is important! Make sure patients provide you with the CORRECT Certifying Physician name, which can be a PCP or an Endocrinologist. Have your patients choose at least two or more shoes to prevent backorders due to Covid-19. Tell your patients you will call them when their shoes arrive and instruct them to wait at least six weeks before calling you for status.

Use short simple wording in your fax covers when requesting signatures and notes from Certifying Physicians. Get all THREE signed documents you are required to get. This has become easier due to recent LDC changes that allow NP and PA’s to perform those face-to-face diabetic exams.

Check your shoe and insert orders for accuracy as soon as you receive them and schedule your patient before the dispense-by date.

The day you dispense is your Date of Service. Have your patient sign the Proof of Delivery and complete your in-office dispensing exam with required elements - what you dispensed, your objective opinion on the fit while the patient was wearing their shoes, how the patient found the fit and, if dispensing pre-fabs inserts, the heat method used.

Utilizing the above tips can help your practice dispense diabetic shoes more efficiently!