Patients Not Spending Enough Time in Custom Shoes

Patients prescribed custom-made footwear for preventing diabetic foot ulcers are not wearing their footwear enough, according to the results of a study published online on January 15, 2013, by Diabetes Care.

Researchers studied 107 diabetic patients with neuropathy, a recently healed plantar foot ulcer, and prescribed custom-made footwear. Using a shoe-worn monitor, the researchers observed footwear use during 7 consecutive days. Patients logged time away from home and daily step count was measured using an ankle-worn monitor. The researchers then measured adherence by comparing the total number of steps to the number of steps taken while the prescription footwear was worn.

Researchers found that adherence to wearing custom-made footwear was insufficient. Most participants did not wear the footwear at home which is where the most walking takes place. Patients with a lower body mass index, more severe foot deformity, or more appealing footwear were more likely to wear the footwear. The researchers note that this low adherence is a major threat for reulceration and suggest that prescribing specific footwear for indoors may increase adherence.