Questions about diabetics and footwear

Ralph Baker Jr. sands down a custom made shoe insert at Ralph Baker's Shoes. Photo by Andy Mooney, Salisbury Post.

By Ralph Baker Jr.

Special to the Salisbury Post

Question: Why is it important for diabetics to have special shoes?

Answer: The statistics speak for themselves. There are 24 million cases of diabetes in the United States. Sixty percent to 70 percent of people with diabetes have some degree of nerve damage. The chances of developing a foot ulcer are as high as 25 percent in these folks. Not only are foot ulcers hard to heal, but they often lead to amputation. There are 60,000 amputations in this country every year, but it has been proven that prevention programs could reduce amputations by as much as 85 percent.

While these shoes are not a miracle cure, we know that improper shoes are the trigger for numerous foot problems. Many times people develop foot complications from wearing shoes that do not fit correctly regardless of the quality of the shoes. This program ensures that you are properly fit in quality footwear by a trained professional.

Q: If I have Medicare, are the shoes free?

A: The Diabetic Shoe Program should never be thought of as “free shoes.” With the proper documentation from your physician, Medicare will cover 80 percent of the total cost of the shoe package after the annual deductible has been met. The patient is responsible for the other 20 percent, but oftentimes supplemental insurance will cover the expense. The whole reason this program was established in 1995 was to actually save money. The cost of amputations runs over $6 billion a year in this country. The money spent on proper footwear has proven to be a great preventative.

Q: What makes these shoes different than what I can buy in the store?

A: To begin with, the shoe program is a package, not just a pair of shoes. The package covers the shoes themselves, total contact inserts which are molded to the foot to distribute pressure evenly, a comprehensive foot evaluation to determine the needs and condition of your feet, and any modifications that may be necessary. The shoes must meet extensive Medicare guidelines to qualify for the program.

Q: Are all of the shoes ugly?

A: Well, beauty is in the eye of the beholder! I’d be the first to say that these shoes won’t win any fashion awards. However, these look much better than the choices we had 15 years ago, and these are the same styles we sell daily on our retail sales floor. You need to remember that these shoes are designed for a purpose and that purpose is foot health. In most cases, the “pretty shoes” are not the healthiest choices. That being said, we do have some neat looking new styles for men and women but you should never compromise comfort for looks.

Q: I’ve heard it’s harder to get the shoes this year. Is that true?

A: Medicare has made a number of changes this year to ensure that only those that need the shoes will get them. You must be diabetic and have at least one of the following conditions: poor circulation, foot deformity, peripheral neuropathy with callus formation, history of pre-ulcerative calluses, history of previous foot ulceration, or previous amputation.

Give us a call at 704-636-1850 and we’ll mail you a Diabetic Certification and prescription along with a letter for your doctor. You’ll need to take these to your family doctor during your next appointment. The certification must be signed by a MD or a DO. Your doctor must also include notes from your chart substantiating the existence of one of the qualifying conditions. Your doctor can fax the documents to us.

Once we get your paperwork, we’ll call you for an appointment. The evaluation appointment typically takes 30 minutes. We try to dispense the shoes during the initial appointment, but oftentimes custom work must be done that takes a week or so.

Q: I’m diabetic, but my feet never hurt. Why should I be concerned about shoes?

A: I’ve seen lots of people and lots of feet in my lifetime in the shoe business and 14 years as a pedorthist. Most of my clients come in complaining that their feet hurt and I work on a solution to address that pain. But, believe it or not, the most serious foot problems are found in those that never complain about foot pain. So often, neuropathy affects the nerves so that pain is not felt and sores are allowed to form on the feet. These sores can quickly lead to infection and amputation. I’ve had countless cases where patients have come in to just get a pair of shoes and I’ve discovered major foot problems that required medical care. That’s why it’s so important to have your feet checked regularly by your doctor.

Q: What if my doctor won’t sign the form?

A: If your doctor says you don’t qualify, then you should consider yourself very lucky and keep doing whatever you’re doing to stay healthy. However, I’m a believer in preventive maintenance, so I’d like to invite you to give our store a try for some really comfortable, good-fitting shoes. You won[0xb9]t need an appointment; our staff is trained and ready to measure and fit you in the best shoes you can get. Of course, Medicare won’t help pay for it, but it will be a small price to keep your feet healthy and comfortable.