New shoe insole design decreases the risk of serious foot infection for diabetics

University of Michigan Health System
Monday, 1 December 2003

U-M certified orthotist explains a new breakthrough to help prevent and treat foot problems

Most people hear the word diabetes and immediately jump to the topic of blood sugar. But did you know that a serious danger surrounding diabetes is foot infection? Now orthotists at the University of Michigan Health System Orthotics and Prosthetics Center are helping diabetics fight calluses, ulcers and even amputation, with a newly designed shoe insole.

"The new design is customized for each patient and works to decrease the amount of pressure and friction on the callus or ulcer while walking," says Ammanath Peethambaran, a certified orthotist at the U-M Orthotics and Prosthetics Center.

More than 60 percent of all non-traumatic lower-limb amputations in the United States occur among people with diabetes — a disease that causes many complications due to the body's inability to produce or properly use insulin. Two effects of diabetes, nerve damage (neuropathy) and poor circulation, only help to aggravate blisters and calluses on the feet. And if the wounded areas are left untreated, infections may develop and lead to gangrene or even amputation.

The new insole acts as a preventative tool and a treatment option for diabetic neuropathy patients with calluses and ulcers.

The previous insole used by diabetic patients focused on alleviating pressure, but did not absorb the friction at the ulcer or callus area. The new dynamic design incorporates a solution to relieve both pressure and friction. Instead of the foot sliding or rolling inside the shoe, the insole moves and absorbs the pressure and friction while walking. The design helps the foot stay fixed in place so the calluses or ulcers are not aggravated.

"We have seen tremendous difference in the healing process between the traditional insole and our new dynamic design," says Peethambaran, who developed and designed the new insole. "A traditional orthoses takes about 70 to 120 days to work, while the dynamic orthoses takes only about 6 weeks to completely heal the wound.

Habits that are good for the soles

Aside from wearing specially designed insoles, diabetic patients can also take preventative steps to reduce their risk of serious foot infection.

Because of the loss of sensation and poor circulation, diabetics should be extra cautious when it comes to the feet.

Here are a few tips to help keep you and your feet healthy:

• Wash your feet in warm water everyday, making sure to dry them completely, especially between the toes.


• Inspect your feet everyday for any cuts, sores, blisters or calluses, especially if sensation has been lost to nerve damage or poor circulation. Always check your toes. If you cannot see the bottoms of your feet, use a mirror or ask someone for help.


• Use a pumice stone after a bath or shower to gently soften calluses.


• Wear shoes and socks at all times to avoid hazardous materials. Never go barefoot.


• Before wearing your shoes, check inside for sharp edges or objects that may injure your feet.


• Wear socks to warm your feet instead of hot water bottles, heating pads or electric blankets.


• Keep blood flowing to your feet by propping them up when sitting or wiggling your toes. Avoid crossing your legs.


• Let your doctor remove corns and calluses.


• Wear shoes that fit just right—not too tight or too loose.


• Always remove your shoes and socks at each doctor's visit so your feet can be examined.

Facts about diabetes and foot care

From the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

• 18 million people in the U.S. have diabetes.


• 15 percent of all patients with diabetes will develop foot ulcers during the course of the disease.


• Comprehensive foot care programs can reduce amputation rates by 45 percent to 85 percent.

According to the Centers for Disease Control (CDC):

• Non-traumatic lower-limb amputations have increased to about 82,000 per year among people with diabetes.

More information on the Dynamic Foot Orthoses:

• The Dynamic Foot Orthoses is currently only available at the University of Michigan Orthotics and Prosthetics Center. To make an appointment, patients must have a prescription from their physician.


• U-M Orthotics and Prosthetics Center (734) 973-2400

For more information, or to contact University of Michigan Health System, see their website at: www.med.umich.edu