Diabetic Amputation Prevention Project

One of the strongest predicting factors for foot ulceration is a previously healed foot ulcer. Foot ulcers often precede amputations, and therefore preventing ulceration is the prime focus of diabetic footcare. This study shows that by making frequent biomechanical modifications to the currently dispensed shoe and insert can prevent the formation and recurrence of diabetic foot ulcers. This study followed 49 participants with previous forefoot foot ulcers for 6 months. Each participant was given one pair of therapeutic shoes, one pair of diabetic inlays, and a log booklet to take home to record daily pertinent information to the study. In addition to their current wound care routine, every 30 days participants returned for shoe modification’s which utilized offloading methods to transfer loads from affected areas to healthier areas of the foot. 10 patients were eliminated from the study due to non-compliance, of the 39 patients who followed through with the study, 38 had no ulcer recurrence, and there were no amputations. The one participant who had an ulcer recurrence was due to non-compliance, wearing sandals rather then therapeutic shoes; showing that patient compliance remains the ultimate reason for success or failure of diabetic shoe wear. However this study still shows the positive effects of proper footwear selection and off-loading. A significant number of patients experienced significant progress, decreased redness, blisters, and or total healing since the application of appropriate footwear.