Patients with diabetes should be treated gently. They are at a much higher risk of ulceration and infection. With decreased blood flow and nervous sensation to the feet the smallest blister or cut can become life threatening if not treated properly. Some suffers have little to no feeling in their feet and toes. They will not notice an area of high pressure that has actually worn a hole in the skin and is now open to a potentially serious infection. It is wise to check the feet thoroughly for calluses or cuts and educate the patient on daily at home foot checks. Nail trimming is advised to be done by someone with experience and sterile instruments. Cold feet that do not have a quick capillary refill are initial signs that extra care should be taken when treating someone with diabetes. Patients will often describe the feet as burning or even tingling when a neuropathy is present.
Neuropathy being more of a byproduct of the diabetes will not be cured using insoles. The insole will be used to alleviate areas of high pressure. A very aggressive device may cause areas of high pressure that have the potential for ulceration. A very soft cover is recommended. It will cradle the foot and offload areas that are exposed to more pressure. A flexible device although not going to correct any significant biomechanical issues can offer support without exposing the patient to unnecessary risk. It is also very wise for the patient to be very diligent with any insoles by daily checking their feet for red pressure points or spots of high wear on the cover. These areas can be adjusted for a more comfortable fit ensuring the patient is safe and happy.