Search

The goal of this article is to create an updated guideline on footwear for people with diabetes that is accessible for interdisciplinary healthcare professionals involved in managing people with diabetes. The authors reviewed several footwear publications, including national and international guidelines, expert consensus documents and clinical knowledge in order to formulate updated recommendations. They recommend healthcare professionals managing people with diabetes should counsel their patients to wear shoe gear that fits, protects and accommodates the shape of their feet. They emphasise that appropriate shoe prescriptions depend largely on the patient's level of risk for diabetic foot ulceration or amputation. In the current Foot Risk Classification System, a risk- and treatment-based approach has been advocated that divides risks with appropriate prescription orders. They confine our recommendations regarding shoe prescriptions to patients in Categories 0-3: Category 0 include patients who are not likely to ulcerate; Category 1 include patients who have complete loss or have diminished protective sensation; Category 2 include patients with loss of protective sensation and presence of deformity with or without peripheral arterial disease (PAD); Category 3 include patients who have a history of previous ulceration(s) and/or amputation(s). Appropriate offloading devices can prevent and/or heal patients in respective categories. This guideline contains categories with respective offloading devices to protect and heal foot-related complications in patients with diabetes. It includes recommendations to guide healthcare professionals in selecting the most appropriate footwear to meet the specific needs for individuals with diabetes. [ABSTRACT FROM AUTHOR]

Over the past generation, attention has been rightly focused on assessing the vascular and neurological status of people with diabetes to assess overall risk for ulceration and amputation. While musculoskeletal assessment has been discussed, it has often not received direct attention in the recent medical literature. In this article, the authors describe methods to perform a thorough musculoskeletal exam to better assess potential pathomechanics leading to foot and ankle deformities in order to provide specific prophylactic and therapeutic treatment. For each anatomic location, the authors will describe the basis for the examination, the examination technique and define abnormal findings. [ABSTRACT FROM AUTHOR]