Orthopedic made-to-measure shoes for diabetics. Long-term 5-year outcome

For patients with diabetes mellitus and diabetic foot syndrome customized orthopedic shoes represent the most effective treatment to avoid foot ulceration and amputation. A total of 53 patients suffering from diabetes and treated with customized orthopedic shoes for more than 5 years were included in the study. Of the patients 91% had peripheral artery occlusion disease, polyneuropathy and diabetic neuropathic osteoarthropathy (DNOAP) and in nearly 25% amputation of one limb had already been carried out. The incidence of ulcers over a time period of 5 years was assessed from the patient records and questioning the patients. Questions on the duration of wearing orthopedic shoes, the durability of the shoes and resulting pain were also included. All patients except for one had problems walking on uneven surfaces. Of the patients 89% claimed to have used their shoes always or nearly always and 25% of the shoes had to be replaced after 1 year. The incidence of ulcers was 38% after 5 years. Treatment with customized orthopedic shoes is an effective method to prevent ulcers and amputation. To be successful it is necessary to control that the shoes are made correctly. Not all shoes last as long as 2 years.