Cast Is Better Than Shoes

The findings of a recent study reported in Diabetes Care suggest that a nonremovable cast helps diabetic foot sores or ulcers heal faster than special shoes, which are traditionally used. Physicians usually recommend the use of shoes or crutches to reduce pressure on the ulcer. For these devices to work, however, patients must use them consistently for several weeks at a time. Unfortunately, many patients do not comply with that course of treatment.

Because compliance is so critical, the researchers designed and tested a cast that might enhance compliance and thereby improve ulcer healing. The cast is made of fiberglass, with rubber heels placed around an opening that allowed access to the ulcer site. For the study, 42 diabetics with deep or long-standing ulcers wore the cast, and 51 diabetics with less severe ulcers were treated with special shoes. The results showed that 81% of cast-treated patients experienced ulcer healing, compared with 70% of shoe-treated patients. Furthermore, the average healing time in the cast group was 69 days, nearly half the time seen in the shoe group.