Some feet require custom-fitted shoes or inserts for a comfortable fit. Medicare Part B covers 80% of the cost of certain special shoes and inserts for people with diabetes. If you have Medicare Part B coverage, you may qualify for one pair of custom-molded shoes (including inserts) and two additional pairs of inserts or one pair of depth shoes (shoes with extra room to allow for differently-shaped feet and toes or for special inserts made to fit your feet) each year. Some private insurance carriers cover therapeutic shoes as well. To qualify for Medicare reimbursement, the doctor who provides your diabetes care must sign a statement certifying your need for these shoes, and a podiatrist or other qualified physician must write you a footwear prescription.
Not too hot, not too cold
Protect your feet from temperature extremes. Loss of sensation means you may not know if you’re burning your feet on the beach or getting frostbite in the cold. At the beach, wear light canvas shoes while you’re on the sand and swimming shoes while you’re in the water to protect your feet from sharp objects. Put sunscreen on any parts of your feet that are exposed to the sun. In cooler weather, avoid putting your feet too close to the radiator or the fireplace. Hot water bottles and heating pads can be hotter than you think and cause minor burns, so it’s safer not to use them. They might also compress the small blood vessels of the feet and hinder circulation. If your feet are cold, wear socks and warm slippers. Lined boots are great for the cooler temperatures of winter.
Take care to check your feet often in the winter to make sure you aren’t developing frostbite. Frostbite usually affects the toes before it affects other parts of the feet, and it is characterized by hard, pale, cold, and numb skin that becomes red and painful when warmed. If you experience mild frostbite, wrap your feet in warm clothing or warm them with your hands — but never rub the frostbitten area. If the frostbitten area is larger than the size of a quarter, you should have your doctor look at it. If you experience severe frostbite, characterized by grayish blue or black skin, get medical attention immediately.
Keep the blood flowing
Make sure you have good blood flow to your feet. Loss of blood flow can starve and destroy soft tissues in the foot. Sitting for long stretches of time can restrict the flow of blood to legs and feet. A good remedy is to put your feet up on an ottoman or on the couch while sitting. Every once in a while, rotate your ankles, wiggle your toes, and stretch your feet to get the blood moving. Crossing your legs for long periods can also restrict the flow of blood. Tight socks, elastic or rubber bands, and garters can all be culprits in reducing circulation to your feet and legs. Smoking constricts blood vessels throughout your body, especially in the extremities, so if you smoke, stop. Your health-care team can help you stop smoking. Reducing high blood pressure and high cholesterol levels will also help to maintain the circulation to your feet and legs.
If you don’t already get regular exercise, increase your physical activity. You and your health-care team can design a program of activity that not only fits your needs, but also provides enjoyment and enhances your quality of life. Sports that involve running and jumping are hard on the feet, but walking, social dancing, swimming, and bicycling are great exercise and easier on the feet. Low-impact, chair, or water aerobics can also be good exercise choices. A good yoga teacher can help you develop a routine that gently stretches the body and increases circulation all over. Whatever you do, choose your athletic shoes carefully and wear clothing that doesn’t bind.