Proper Diabetic Foot Care is Not Optional!

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Diabetic Foot Care

Approximately 84% of non-traumatic major amputations among people with diabetes are preceded by a diabetic foot ulcer. Most cases of lower extremity limb loss in the United States occur among people with diabetes who have a diabetic foot ulcer.

avoid a diabetic foot with custom orthotics

Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention Diabetes Care. 1990;13:513–21.


1. Foot Basics
2. Foot Care Essentials
3. Selecting the Right Custom Foot Orthotic
4. Selecting the Right Shoe


Foot Basics


Each foot has 26 bones that come together to create 33 joints.

Clearly, there’s a lot of movement here.

Additionally, your feet are your foundation of your entire body and therefore subject to stress from body weight and gravity.

To reduce stress and the risk of ulceration or, worse yet…amputation, proper foot function and foot care is essential - a little effort goes a long way!

Taking proper precautions and acting swiftly if problems arise is not optional.

The foot has a normal optimal ‘arch-up’ alignment designed to optimize the passage of force with each step.

When force is not equally distributed over the entire surface of each foot, you’ve got a problem.

The end result of this dysfunction is a wear-and-tear pattern that encourages friction and your risk of ulceration.

"Unequal distribution of stress on the plantar surface of the foot during the gait cycle predisposes prominent areas of the foot to repetitive trauma and ultimately full-thickness skin ulceration."

Call your doctor immediately following injury or at the onset of visualized abnormalities no matter how trivial you feel it is.

Protect the foundation of your body, your feet, and you'll be glad you did in the years to come!

Cavanagh PR, Bus SA. Off-loading the diabetic foot for ulcer prevention and healing. J Vasc Surg 2010; 52.


Foot Care Essentials


Nightly inspection:
Both feet - quick and painless. Catch developing problems early and prevent something potentially more serious from gaining hold. Grab a mirror and look at each foot, including in-between each toe and at the entire bottom. Inspect carefully for:

  • Cracks
  • Swelling
  • Discoloration
  • Fluid Drainage
  • Inflammation
  • Redness



  • Always check the bath water with a thermometer, at least your hand, before placing your feet into the water.
  • Do not warm cold feet with a hot water bottle, heating pad, or next to a fire. Beware of the floor heater while traveling by car.
  • Protect your feet from sunburn with sun block when applicable.
  • Do not “ice down” your feet, even if they feel like they're burning.
  • Do not attempt to treat foot problems yourself. Never use any chemical agent or medicated pad on your feet such as over the counter products for the removal of corns, calluses and warts.
  • Avoid store bought pads and arch supports; they're not custom and may place excessive pressure on certain areas of your foot.
  • Call your doctor immediately if you think you have an infection.

Your feet contain 25% of all the bones in your body!

Protect the health of your feet and protect the foundation of your entire body for a brighter future.


Selecting the Right Custom Foot Orthotic


Equal distribution of body weight across the entire surface of each foot goes a long way in the prevention of diabetic foot ulceration and amputation.

Approximately 84% of amputations among people with diabetes are preceded by a foot ulcer.

"Correcting the unequal distribution of repetitive stress in each foot when walking goes a long way in the prevention of ulcers, and that's exactly what we've accomplished. Our new optically calibrated diabetic foot orthotic is quite an accomplishment," says Dr. Doperak with Arizona Orthotics.

Diabetics have long awaited an orthotic soft enough to stand on, yet accurate enough to evenly dissipate force over the entire foots surface.

Until now, calibrating the softer plastic shell necessary to make such an orthotic proved difficult.

"Using our previous generation calibration machine, a sharp pin was inserted into a calibration reference point on the bottom of the plastic shell. Soft compressive materials were either pierced or compressed during this process. Therefore, we chose not to offer an uncalibrated EVA product, since it did not offer consistent results," explains world-renowned Dr. Edward Glaser, DPM with Sole Supports™.

Dr. Doperak continues, "Our new and exclusive optical calibration means the softer plastic shell is fine-tuned to match:

1. Each Foot's 3-D MASS Position Impression
2. Body Weight
3. Foot Flexibility
4. Activity Level when applicable.”

When selecting the right fit orthotic, there are 2 essential components:
1. Be sure to obtain an Accurate 3-D MASS (Maximal Arch Supination Stabilization) Position Impression – See Figure 1 below.

Mass Position Casting

Figure 1. An accurate 3-D impression must be taken seated (non-weight bearing)! Gravity and body weight are an overwhelming stress on the 26 bones and 33 joints of each foot causing the arch to flatten. Never purchase an orthotic from a weight-bearing analysis of your foot!!!

2. Be sure the orthotic is Precision Calibrated specific to body weight, foot flexibility and activity level.

Precision Calibration provides a biomechanical advantage reserved for only the highest quality of orthotics.

These 2 components built into a made-from-scratch orthotic remain the only way to equally distribute repetitive force and reduce stress specific to individual needs.

"We're thrilled to finally offer a calibrated diabetic orthotic that's made with such precision and care,” says Dr. D."

Exciting news only gets better thanks to Plastazote®!

Plastazote foam topcovers adorn this made-from-scratch diabetic exclusive orthotic.

Plastazote foam is produced using only pure nitrogen whereas other foams contain chemicals that can irritate the diabetic's sensitive foot.

Plastazote is an industry standard due to its ability to conform rapidly. In other words, this topcover fits-like-a-glove and is just what the doctor ordered.

Plastazote foam topcovers

Plastazote foam topcovers


Selecting the Right Shoe


Removable inserts are best to accommodate a full length orthotic.

When selecting new shoes be sure to take your new orthotic with you.

This will help you learn whether the shoe you're considering is in fact a good match.

Shoes that do not fit properly may result in repetitive friction and lead to ulceration.

Here are some tips to help reduce the risk of foot problems when shopping for the right fit shoe:

  • Shop for new shoes at the end of the day. Since feet naturally swell to some degree, this will ensure a better fit.
  • Be sure to take your orthotics with you.
  • Each shoe needs to conform to the shape of your foot with the orthotic in place.
  • Buy shoes made with soft leather uppers able to adapt to the shape of your foot.
  • Walk around the store in each shoe to ensure a comfortable fit.
  • When the shoe is on your foot, you should be able to freely wiggle all of your toes.
  • If the shoe feels too tight, don't buy it; there is no such thing as a break-in period.
  • Limit heel height to two inches or less to keep forefoot stress to a minimum.
  • Always inspect the inside of each shoe with your hand, checking for sharp or loose objects before putting your foot in.
  • Keep those feet protected. Limit wear time for open-toed or open-heeled shoes and sandals.
  • Always wear socks with shoes to reduce friction, provide insulation, and absorb perspiration.
  • Do not wear mended socks or socks with holes in them, and avoid socks or stockings with seams. Wear cotton, wool or a blend, but never 100 percent synthetic material. Do not hold up socks or stockings with a garter or elastic band.

In conclusion, as you can see, if you’re a diabetic there is a lot at stake when it comes to the health and care of your feet.

If you remember only one piece of advice, please remember this…“Do Not EVER settle for a one-size-fits-all approach to your special needs.”

Call Dr. Dave at Arizona Orthotics today, 480-307-4060 and let's get you feeling good again!

Dr. David Doperak

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