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The Role of a Certified Orthotist in the Management of Diabetes

November 14th is World Diabetes Day, so we decided to focus this month’s article on the role of a certified orthotist in the management of diabetes! 

Diabetes is one of the most common chronic diseases in our society. In North America, there are over 500,000 new cases of diabetes diagnosed each year and about half of these individuals will have Diabetic Neuropathy (nerve damage). Nerves in the legs and feet become damaged and sensation becomes impaired. Living without pain sounds pretty good, but it comes at a high cost. Pain is the body’s way of telling you something’s wrong so you can take care of yourself. If you don’t feel pain in your feet, you may not notice a cut, blister or sore. Individuals with diabetes have compromised vascular systems, leading to poor blood flow and reduced healing capabilities. 

Non-healing foot ulcers are responsible for 85% of all lower limb amputations. Of these individuals, the Canadian Diabetes Association estimates half could have been prevented with daily foot inspections. A key focus of diabetic foot management is prevention and early treatment of the initial ulceration.

The prevention and management of a neuropathic foot should include patient education, wound care and off-loading pressures. Orthotists are biomechanical specialists that provide orthoses to off-load certain areas of the foot. These devices can also be designed to redistribute pressure away from areas of ulceration or areas at risk of ulceration.

Foot Care Practices:

  • Check your feet daily for sores, cuts, blisters and irregularities
  • Have your doctor check your feet regularly
  • Clean cuts or scratches with mild soap and water, cover with dry dressing
  • Always wear clean socks
  • Wear custom foot orthotics that are designed to evenly distribute pressures and offload sensitive areas
  • Wear supportive and comfortable closed-toe shoes that fit well
  • Do not cut your own corns or calluses
  • Do not treat your own in-grown toenails or slivers. See your foot care specialist.


Ulcer Prevention:

Accommodative Foot Orthotics (FO): This style of FO is custom to the individual’s foot and created to redistribute the pressures on the foot, reduce friction and shear forces. Common areas that experience excessive pressures are the big toe and metatarsal heads. Once prescribed by your physician, the orthotist will work with you to design and choose the appropriate materials specific to your needs, comfort level and functional goals.

Therapeutic Footwear: The wide design, extra depth and generous toe box accommodate swollen, sensitive feet. When paired with accommodative FOs, they create a pressure free environment ideal for preventing ulcerations.

The Team at Custom Orthotics of London
(519) 850-4721 | office@customorthoticsoflondon.com | @cool_bracing


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