Diabetic Shoe Program

Qualifications

Diabetics who are covered under Medicare Part B may qualify for extra-depth shoes. Aside from being diabetic, you must meet one or more of the following conditions:

• Peripheral neuropathy with evidence of callous formation
• History of pre-ulcerative callouses
• Foot deformity
• Previous amputation of the foot or part of the foot
• Poor circulation
• History of previous ulceration

Coverage

Provided qualifications are met, Medicare covers 80% of the cost for extra-depth shoes. One of the following will be covered per calendar year:

• One pair of custom molded shoes and two additional pairs of multi-density inserts.
• One pair of off-the-shelf extra-depth shoes including modifications and two additional pairs of multi-density inserts.
• One pair of off-the-shelf extra-depth shoes and three additional pairs of multi-density inserts.
• The patient will also need a certified statement from their primary care physician (M.D. Or
  D. O.) stating they have diabetes. Under most circumstances, we will obtain this statement for our patients, along with providing the required written prescription.

Diabetic Links

• American Diabetes Association
• International Diabetes Federation
• American Podiatric Medical Association
• American Association Of Diabetes Educators
• International Diabetes Center
• Centers for Disease Control
• National Diabetes Information Clearinghouse
• Juvenile Diabetes Research Foundation
• American Dietetic Association

Education

Patient education is crucial for the diabetic. The better you understand your condition, the easier it will be for you to manage it. We hope the above links will help you to learn more about diabetes, its effect on your overall health, and provide you with some of the resources you will need to work your way toward better diabetic health. Regular visits to your primary care physician are a must for maintaining proper blood sugar (glucose) levels.

Diabetic Foot Health

The American Diabetes Association (ADA) estimates that 18.2 million people in the United States have diabetes. Diagnosed cases total 13 million people, undiagnosed total 5.2 million people. In Ross and the seven surrounding counties, approximately 10% of the population has diabetes. This totals 30,000 individuals. The risk for type 2 diabetes increases with age. Approximately 18.3 percent (8.6 million) of the United States population age 60 and over have diabetes. These statistics are staggering. There are several complications associated with diabetes including heart disease and stroke, high blood pressure, blindness, kidney disease, nervous system disease, amputations, dental disease and pregnancy complications. Over 20% of all diabetic admissions to the hospital are due to complications of the diabetic foot.

The ADA reports that 15% of all people with diabetes will eventually develop foot ulcers and that these ulcers frequently become infected and lead to amputation. Many of these complications could have been avoided with patient education, proper care, and tight control of glucose levels. Prevention of diabetic foot problems involves daily inspections, good glucose control and regular visits to your doctor. The following guidelines can help you to achieve these goals.

Guidelines for the Diabetic Foot

Inspect feet daily for blisters, cuts, scratches, And skin breakdown between toes. Use a mirror
If necessary.

Wash feet with a mild soap. Dry carefully, especially between toes. Use medicated foot powder as prescribed for fungal infections.

Avoid extreme temperature. Test water before bathing. If you are unable, have a family member test for you.

If feet are cold at night, wear wool socks.

DO NOT apply external sources of heat such as hot water bottles or heating pads.

DO NOT place feet near an automobile heater.

DO NOT use chemical agents for removal of corns or callouses. Always have these removed by
Your doctor.

Inspect insides of shoes daily for foreign objects, protruding nails, torn linings, and bunching up of shoe construction material.

Wear properly fitted stockings. DO NOT wear mended stockings. Avoid stockings with seams. Change stockings daily. Be careful of pressure on toes from stretch socks.

DO NOT wear garters that are circular. If garters are necessary, they should be attached to a
Garter belt.

Wear properly fitted shoes. Avoid open-toes or pointed shoes. Break in new shoes gradually. If necessary, have another family member inspect your feet after wearing new shoes.

NEVER WALK BAREFOOTED. This includes going to the bathroom at night, on surfaces such as sandy beaches, concrete around swimming pools, etc...

DO NOT do bathroom surgery on corns and callouses. Follow special instructions from your physician.

See your podiatrist regularly to ensure proper diabetic foot health. Be sure anyone caring for your feet knows that you are a diabetic. This includes your shoe salesmen.

Recognize that as you get older your feet will tend to spread and require a longer, wider shoe. Do not insist on the same size you wore when you were younger.

For more information regarding Medicare coverage issues for the diabetic, please click on this link to view the Medicare Coverage of Diabetes Supplies and Services official booklet from the Center for Medicare Services website.