Preventive treatment of foot deformities in type 1 diabetic patients aged 15-50 years--an epidemiological and prospective study.

Abstract

OBJECTIVES: To prevent worsening of foot deformities in diabetic patients. DESIGN: A population-based and prospective study. SUBJECTS: All patients in the county of Umeå with Type 1 diabetes mellitus (DM) (n = 308) aged 15-50 years. MAIN OUTCOME MEASURES: Examination and individual education was performed. Patients with the most pronounced foot deformities (n = 67) were fitted with custom-made insoles and had repeated foot examinations. An identical examination was used at a 3-year follow-up. RESULTS: Patients who were fitted with insoles had higher sensory thresholds for vibration compared to those with no insoles. They were older and had longer duration of DM. Improvement of foot deformities was significantly more common in patients after treatment with insoles than in patients without. Plantar ulcers did not occur in patients with moulded insoles. CONCLUSION: Information, follow-up examinations and moulded insoles improve neuropathic foot deformities in many patients, even in those with pronounced deformities.