Did you know that according to the American Diabetes Association, 29.2% of Americans age 65 and over have diabetes? Additionally, up to 10% of diabetics develop foot ulcers and up to 25% of foot ulcers lead to limb amputation within 6 to 18 months of initial evaluation. These numbers only increased during the COVID-19 pandemic due to diabetics deferring their health care, with many primary care physicians and podiatrists reporting their case load of toe amputations increasing by as much as 50% in 2020 and 2021. A study conducted at the US Department of Veterans Affairs in Seattle a few years ago found that 30 percent of amputations started as improperly fitting footwear, which can lead to ulcers and amputations.
The Therapeutic Shoe Bill
We don’t have a cure for diabetes. But fortunately, we know how to properly take care of diabetic feet which are subject to complications caused by diabetes. In 1993, the US Congress passed the Therapeutic Shoe Bill, mandating Medicare to pay for therapeutic shoes and inserts for qualifying diabetics with foot conditions such as poor circulation, neuropathy, and callousing. Most private insurers have followed Medicare’s lead and cover therapeutic shoes and inserts with little or no coinsurance.
Even with this benefit, fewer than 20 percent of eligible beneficiaries use the Medicare benefit provided in the Therapeutic Shoe Bill to receive therapeutic shoes and inserts. There are two primary reasons for this: 1) lack of patient and doctor awareness, and 2) lack of providers with the expertise to properly fit the shoes, manufacture the accommodative inserts, and carry the patient through the necessary doctor and insurance paperwork.
Saving Diabetic Toes and Feet
Raising awareness of this benefit is the purpose of articles such as this. There are a number of providers who are able to fit and provide therapeutic footwear, including most podiatrists and companies like Priority Footwear, the only company in the Pacific Northwest that is exclusively dedicated to the mission of saving diabetic toes and feet.
If you are diabetic and think you may qualify for therapeutic footwear, talk to your doctor or call a company like Priority Footwear. Bring a copy of this article to your appointment and recognize that the health of your feet begins with you. Lastly, follow some simple foot care tips:
- Wash and check your feet every day
- Rub a thin coat of lotion over the tops and bottoms of your feet, but not between your toes
- Keep the blood flowing to your feet by being active every day
- Trim your toenails each week or when needed
- Protect your feet from hot and cold
Wear comfortable shoes that fit well and protect your feet
- Check in with your primary care physician regularly as part of taking care of your diabetes