I saw a patient today who received orthotics, or insoles, from a shoe store. She was told that these were "custom"; however, there was really nothing "custom" about them! They were not prescribed by a podiatrist, and the material was not accomodative and instead quite rigid and uncomfortable. And the worst part about it was... the shoe store had labeled the orthotics wrong! The left foot orthotic was in the right shoe, and vice versa. Thank goodness there were no immediate ill effects with the wrong orthotics in the wrong shoe, but this could be potentially detrimental.
So, bottom line... when choosing orthotics, there are several things to keep in mind as a diabetic. The best option is really custom made orthotics made per your prescription from a podiatrist. This way, you know that your podiatrist has done a thorough exam and has accounted for all the issues with your foot, including possibly bony deformities and diabetic neuropathy, which will prevent you from getting sores. In addition, your doctor can determine if diabetic shoes are for you in addition to the custom insoles. Another option if the custom orthotics are not possible is a good semi-custom orthotic that can be purchased and accommodated by your podiatrist. The most important thing is to get your feet examined and checked often, in order to stave off potential foot problems.
Tuesday, December 14, 2010
Sunday, November 14, 2010
Bret Michaels is a diabetic
Bret Michaels, the lead singer of the rock band Poison, is a type 1 diabetic. This is also called early onset or juvenile diabetes, because of when he was diagnosed at age 6. He is now a spokesperson and was selected as the face of diabetes by the American Diabetes Association. He has a public service announcement, and even incorporated his diabetes into his VH1 reality show "Rock of Love" where he tested potential matches by having the ladies practice injecting insulin into an orange!
His face as the face of diabetes is a good choice. It shows how mainstream diabetes really is... and that it is a disease that you can live with for a long time if you take precautions such as diet, exercise, and monitoring blood glucose levels very closely. Bret says he is used to using blood glucose monitors and it is part of his rock star touring lifestyle. He still uses insulin shots instead of the pump, but he says that is for "cosmetic reasons." Many diabetics use a pump that eliminates the need for insulin syringes and injections; that is his choice. He truly shows that diabetes has many faces... any many choices in managing it.
His face as the face of diabetes is a good choice. It shows how mainstream diabetes really is... and that it is a disease that you can live with for a long time if you take precautions such as diet, exercise, and monitoring blood glucose levels very closely. Bret says he is used to using blood glucose monitors and it is part of his rock star touring lifestyle. He still uses insulin shots instead of the pump, but he says that is for "cosmetic reasons." Many diabetics use a pump that eliminates the need for insulin syringes and injections; that is his choice. He truly shows that diabetes has many faces... any many choices in managing it.
Tuesday, November 2, 2010
Can I start an Exercise Program?
In my office, I see a lot of diabetics for preventative foot care, and each and every one of them inevitably will ask me my opinion on exercising and the proper way to start. If you have recently been diagnosed with diabetes, or if you are overweight, it is important to speak to your pirmary care doctor before you start and exercise program, no matter how slow you start out.
Here are some other tips to keep in mind as a diabetic:
-Make sure you have proper fitting shoes. Very often our patients have prescription accomodative orthotics, or insoles, in their shoes to prevent areas of pressure from building up. Also, many of our patients have prescription diabetic shoes, either walking shoes or gym shoes, that are fitted by our certified medical assistants to make sure there are no pressure spots. We urge our patients to break in the shoes by wearing them an hour or two and gradually increasing the time worn each day, inspecting your feet for areas of redness or pressure.
-Make sure you have proper socks. I recommend a cotton blend with nylon or another material that "wicks moisture away" from the skin. This will prevent blisters in pressure areas, and also prevent fungus or athletes foot.
-Start off slowly, with a low impact activity such as walking. Build up the time gradually, either by distance or by time. If you have joint problems, consider swimming or aqua aerobics
-Keep water near by, and keep well hydrated, especially on hot days
-Always wear an ID tag indicating that you have diabetes to insure proper treatment in case there's a problem when you're exercising or you have an injury.
-Try to exercise at the same time every day for the same duration. This will help control your blood sugar. Exercise at least three times a week for about 30 to 45 minutes.
Here are some other tips to keep in mind as a diabetic:
-Make sure you have proper fitting shoes. Very often our patients have prescription accomodative orthotics, or insoles, in their shoes to prevent areas of pressure from building up. Also, many of our patients have prescription diabetic shoes, either walking shoes or gym shoes, that are fitted by our certified medical assistants to make sure there are no pressure spots. We urge our patients to break in the shoes by wearing them an hour or two and gradually increasing the time worn each day, inspecting your feet for areas of redness or pressure.
-Make sure you have proper socks. I recommend a cotton blend with nylon or another material that "wicks moisture away" from the skin. This will prevent blisters in pressure areas, and also prevent fungus or athletes foot.
-Start off slowly, with a low impact activity such as walking. Build up the time gradually, either by distance or by time. If you have joint problems, consider swimming or aqua aerobics
-Keep water near by, and keep well hydrated, especially on hot days
-Always wear an ID tag indicating that you have diabetes to insure proper treatment in case there's a problem when you're exercising or you have an injury.
-Try to exercise at the same time every day for the same duration. This will help control your blood sugar. Exercise at least three times a week for about 30 to 45 minutes.
Sunday, October 24, 2010
Socks and more socks!
Have you seen the latest trend in socks? The latest I heard about are these expensive "socks to the stars." It is now known that 36% of women have no problem spending over $25 on a pair of socks for fashion. Does that seem like a lot? The designer company, Rodarte, is manufacturing a sock that costs upwards of $500. This is one pair you don't want to lose in the dryer! These $500 multicolored hand-crocheted socks are made of silk mohair yarn and soft alpaca wool. Can you say dry clean only?
As a diabetic, you don't have to spend upwards of $25 for a good pair of diabetic friendly socks. Our office sells diabetic socks that have no seams, and have a graded elastic so it does not irritate the skin. Also, we advise our patients that it is not essential, in fact it is not preferable, that diabetics use socks that are 100% cotton. Think of a wet T-shirt, how it holds moisture and causes chafing on the skin. The same thing happens with feet when they sweat. If the socks are 100% cotton, more chances for retaining moisture, causing blistering, and increased chance for athletes foot or fungal infections. The best material for socks is one that is a cotton blend with another material such as polyester or nylon, on even a "dry-weave" that will wisk moisture away from the skin.
So don't ever feel that you have to spend big bucks to get proper socks for those diabetic feet. And you'll be able to wash them.
As a diabetic, you don't have to spend upwards of $25 for a good pair of diabetic friendly socks. Our office sells diabetic socks that have no seams, and have a graded elastic so it does not irritate the skin. Also, we advise our patients that it is not essential, in fact it is not preferable, that diabetics use socks that are 100% cotton. Think of a wet T-shirt, how it holds moisture and causes chafing on the skin. The same thing happens with feet when they sweat. If the socks are 100% cotton, more chances for retaining moisture, causing blistering, and increased chance for athletes foot or fungal infections. The best material for socks is one that is a cotton blend with another material such as polyester or nylon, on even a "dry-weave" that will wisk moisture away from the skin.
So don't ever feel that you have to spend big bucks to get proper socks for those diabetic feet. And you'll be able to wash them.
Monday, August 23, 2010
Diabetic Shoes
A patient asked me, "What kind to shoes should I be wearing as a diabetic?" For the answer, there are a few guidelines to follow. The best thing to do first is to see a podiatrist and have your feet evaluated. Not only will you get a thorough exam, but you will also receive invaluable information and education about your feet and the structure of your feet. In addition, many podiatrist offices like ours, Prairie Path Foot and Ankle Clinic, are certified to fit and dispense diabetic shoes such as Dr. Comfort brand, if you qualify per Medicare standards.
For those patients whom that is not an option, then there are several qualities to look for in a shoe. Firstly, it should have a wide toe box. This is in order to accommodate any foot structural deformities, such as bunions or hammer toes. This would prevent any irritation against the skin that could turn into an ulcer or an open sore.
The next thing to look for is good padding along the sole of the shoe. Some have extra cushioning in order to accommodate any bony prominences or areas of increased pressure, again, to prevent a sore from forming. In addition, the shoe should be easy to adjust with laces or velcro, in order to take into account the fact that the feet may swell at the end of the day, and the shoe can easily expand.
Most importantly, until you are confident that your shoes are well fitting and free of risk, you must break in your shoes. Wear them a couple of hours a day, and slowly increase until you can wear them all day. Be sure to check your feet for areas of redness and irritation, and if you do find this, take the shoes back to where you purchased them and schedule an appointment to have your feet examined again by a podiatrist to make sure no new sores or ulcers have occurred.
Please stop by our office at Prairie Path Foot and Ankle Clinic and see our line of Dr. Comfort diabetic shoes. After a thorough diabetic foot exam, our Certified Podiatric Medical Assistant will be happy to assist you in picking out a pair of shoes. Happy Walking!
For those patients whom that is not an option, then there are several qualities to look for in a shoe. Firstly, it should have a wide toe box. This is in order to accommodate any foot structural deformities, such as bunions or hammer toes. This would prevent any irritation against the skin that could turn into an ulcer or an open sore.
The next thing to look for is good padding along the sole of the shoe. Some have extra cushioning in order to accommodate any bony prominences or areas of increased pressure, again, to prevent a sore from forming. In addition, the shoe should be easy to adjust with laces or velcro, in order to take into account the fact that the feet may swell at the end of the day, and the shoe can easily expand.
Most importantly, until you are confident that your shoes are well fitting and free of risk, you must break in your shoes. Wear them a couple of hours a day, and slowly increase until you can wear them all day. Be sure to check your feet for areas of redness and irritation, and if you do find this, take the shoes back to where you purchased them and schedule an appointment to have your feet examined again by a podiatrist to make sure no new sores or ulcers have occurred.
Please stop by our office at Prairie Path Foot and Ankle Clinic and see our line of Dr. Comfort diabetic shoes. After a thorough diabetic foot exam, our Certified Podiatric Medical Assistant will be happy to assist you in picking out a pair of shoes. Happy Walking!
Sunday, January 31, 2010
Why is my foot ulcer not healing?
A diabetic patient asked me the other day, "Dr. Arain, why is this ulcer not closing? I feel like it has been on the bottom of my foot forever!"
An ulceration is a sore or opening in the skin that may be very superficial, or may be very deep and go through the layers of skin, and maybe even down to the bone. This is more common in diabetics, and that is why it is of the utmost importance for people with diabetes to see a podiatrist, or foot and ankle specialist, on a regular basis.
My answer to her question was that there are several reasons why a wound or ulceration will not heal.
The first thing you look at is infection. If the sore is infected, it will never heal. Signs of infection include redness, purulent drainage, pain, or swelling. However, a wound may not look infected, or it may be so deep that the podiatrist can "probe" to bone. If this is the case, the podiatrist may need to take a culture, or scraping, to see if there is indeed bacteria in the wound that is infecting the wound. If in fact an infection is present, then an oral or IV antibiotics will take care of the infection and allow the body to heal.
The second thing to consider is lack of blood flow. If the wound is simply not getting enough blood, then with or without infection, the actual tissue is not getting enough nutrients to allow it to heal. In that case, your podiatrist can work with a vascular specialist to determine why there is lack of blood flow and possibly intervene to improve the bloodflow in order to improve chances of healing.
The third aspect to look at is pressure. A person without diabetes can handle fluctuations in pressure of simple weightbearing or walking, however sometimes due to bony deformities, the pressure of the bone or simply of an ill-fitting shoe will prevent the ulcer from healing. Think of it as "micro-trauma" to the sore. In that case, an accomodation can be made to the shoe or even alter the shoe gear temporarily or permanently in order to relieve pressure.
If all of these issues are resolved and the wound is still present, then look at other factors such as nutrition, and other metabolic issues, and even other impacts on health such as tobacco use or alcohol use. On the other hand, sometimes the wound may need some outside help such as wound care elements. There are many options, including topical gels, and bioengineered skin substitutes.
Remember, if a wound or ulcer is not healing, there has to be a reason, and your podiatrist can help. If you are in the Chicago area, please visit our clinic in Elmhurst, Prairie path foot and ankle clinic at 630-834-FOOT, or our Schaumburg location at Schaumburg Foot and Ankle Clinic 847-985-8380.
Please visit our websites at elmhurstfootdoc.com and schaumburgfootdoc.com
An ulceration is a sore or opening in the skin that may be very superficial, or may be very deep and go through the layers of skin, and maybe even down to the bone. This is more common in diabetics, and that is why it is of the utmost importance for people with diabetes to see a podiatrist, or foot and ankle specialist, on a regular basis.
My answer to her question was that there are several reasons why a wound or ulceration will not heal.
The first thing you look at is infection. If the sore is infected, it will never heal. Signs of infection include redness, purulent drainage, pain, or swelling. However, a wound may not look infected, or it may be so deep that the podiatrist can "probe" to bone. If this is the case, the podiatrist may need to take a culture, or scraping, to see if there is indeed bacteria in the wound that is infecting the wound. If in fact an infection is present, then an oral or IV antibiotics will take care of the infection and allow the body to heal.
The second thing to consider is lack of blood flow. If the wound is simply not getting enough blood, then with or without infection, the actual tissue is not getting enough nutrients to allow it to heal. In that case, your podiatrist can work with a vascular specialist to determine why there is lack of blood flow and possibly intervene to improve the bloodflow in order to improve chances of healing.
The third aspect to look at is pressure. A person without diabetes can handle fluctuations in pressure of simple weightbearing or walking, however sometimes due to bony deformities, the pressure of the bone or simply of an ill-fitting shoe will prevent the ulcer from healing. Think of it as "micro-trauma" to the sore. In that case, an accomodation can be made to the shoe or even alter the shoe gear temporarily or permanently in order to relieve pressure.
If all of these issues are resolved and the wound is still present, then look at other factors such as nutrition, and other metabolic issues, and even other impacts on health such as tobacco use or alcohol use. On the other hand, sometimes the wound may need some outside help such as wound care elements. There are many options, including topical gels, and bioengineered skin substitutes.
Remember, if a wound or ulcer is not healing, there has to be a reason, and your podiatrist can help. If you are in the Chicago area, please visit our clinic in Elmhurst, Prairie path foot and ankle clinic at 630-834-FOOT, or our Schaumburg location at Schaumburg Foot and Ankle Clinic 847-985-8380.
Please visit our websites at elmhurstfootdoc.com and schaumburgfootdoc.com
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