The 130th Annual Meeting of APHA

Abstract #41835

ML McNeill, DPM¹, Lawrence Lavery, DPM, MPH¹, and RP Wunderlich, DPM². (1) Orthopaedics and Rehabilitation, Loyola University Medical Center, 2160 S. 1st Ave, Building 54, Maywood, IL 60153, 773-832-1565, mistydpm@yahoo.com, (2) Diabetex, diabetex, San Antonio, TX 78251

A large proportion of foot wounds in persons with diabetes have been associated with ill-fitting footwear. The purpose of this paper was to compare the size of the footbed in self-selected shoes and professionally fitted shoes in diabetic patient that were high-risk for foot complications. We evaluated 29 patients as part of a diabetic disease management program that fit a high-risk profile for foot complications. These patients had sensory neuropathy with loss of protective sensation and foot deformities and/ or a history of previous foot complications. As part of the prevention program, these patients were fitted by a certified pedorthist for therapeutic shoes/accommodative insoles to protect their feet from repetitive trauma. As part of the foot evaluation the pedorthist used acetate to traced the insole from the shoes the patient chose, the bare foot-standing, and the insole fitted by the pedorthist. The area of the three tracings were measured using an overlay of 0.25 cm squares. This method has previously been shown to be reproducible and reliable in evaluation of wounds. We then measured each insole with a Brannock device to determine the standard size (length and width). We used a repeat measure ANOVA design to compare the area, the maximum width (cm) and the maximum length (cm) of the self-selected vs. professionally fitted shoes. High-risk diabetics’ self-selected shoes were significantly smaller than those fitted by a trained professional in total area, maximum width and maximum length. Conclusion: High-risk diabetics should have footwear fitted by a trained professional in order to eliminate ill-fitting shoes as a source of pathology.

Learning Objectives:

• -To create a sense of awareness regarding appropriate shoegear selection for diabetics.
• -To provide information regarding diabetics misjudgement of appropriate and safe shoegear.

Keywords: Diabetes,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.