A diabetic boot is a device that can help people with diabetic ulcers. People with diabetes are at risk for developing foot ulcers, or open sores on the surface of the skin. A high blood sugar level delays proper wound healing. This can lead to a serious infection, and may even result in the loss of toes, a foot, or a limb.
What are diabetic ulcers?
Diabetic foot ulcers most commonly develop on the ball of the foot or at the bottom of the big toe. A diabetic foot ulcer may also develop at the spot of a callus. Calluses are a frequent occurrence on the feet of people with diabetes. Diabetes-related complications such as foot ulcers are more commonly experienced in people who:
- have had diabetes for longer than 10 years
- have poor blood sugar control
- use insulin
- have received a diagnosis of neuropathy
- have heart disease
Pressure or irritation on the foot can cause ulcers to form. One of the best ways to slow the growth of ulcers is to reduce the pressure. A diabetic boot can take some of the pressure off your foot when you’re walking.
In addition to slowing the growth of an ulcer, the boot can also help stop the spread of an infection. It can then allow other treatments, such as medications or intravenous (IV) antibiotics, to work more efficiently.
How long do I have to wear a diabetic boot?
A diabetic boot may be removable or irremovable. For the best results, some doctors prefer a type of diabetic foot treatment called a total contact cast. This cast creates constant pressure around the foot and can’t be removed. This is important for best results.
One 2003 study found that when people were given a cast that could be removed, they didn’t wear it for the majority of the day. In fact, study participants only took 28 percent of their entire day’s steps with the protective cast boot on. As a result, their recovery time was much longer than people who wore it constantly.
Diabetic ulcers that aren’t accompanied by an infection should heal in six to eight weeks, according to a 2011 study. Complicating factors, such as an infection, may lengthen that recovery time.
Commitment to the treatment is important for recovery. In an older study from 2001, people who wore a total contact cast showed significantly more improvement at 12 weeks than people who wore a removable cast or a half-shoe. However, a more recent study from 2016 found no difference in healing between a cast, a removable boot, and an irremovable boot.
What are the pros and cons of wearing a diabetic boot?
If you’re looking for a quick way to heal your diabetic ulcers, the pros of a diabetic boot may outweigh the cons. There are many other factors, though, that may influence your choice between a total contact cast and versions that can be taken off from time to time.
Before getting a diabetic boot, consider these factors:
- Diabetic boots may shorten recovery time.
- Diabetic boots may prevent or help stop the beginning of an infection.
- Diabetic ulcers may heal more quickly with a total contact or nonremovable cast than with a diabetic shoe or cast that can be removed.
- The best benefit comes from wearing the boot or cast around the clock. For some people, that may be bothersome.
- If your boot is removable, you may be more tempted to remove the boot more often than your treatment plan allows.
- Even with the boot, you need to avoid walking as much as possible. This will ultimately allow your feet to heal faster, but it will reduce your mobility for a bit.
- Other treatments, including antibiotics, may be able to treat the ulcer and infection.
What happens when the boot is removed?
If your boot was nonremovable, you may be tempted to return to life as usual once it’s removed. However, that may not be what’s best for your feet.
You still need to be cautious with your feet and rest as much as possible. Additionally, you’ll need routine checkups with your podiatrist to make sure the wounds are healing correctly and not redeveloping.
How can I avoid having to wear a diabetic boot?
Proper diabetes management will go a long way toward helping you prevent or quickly identify and treat a foot ulcer if one develops. Be sure to:
- Eat well. About 50 percent of your meals should consist of nonstarchy vegetables.
- Exercise regularly.
- Routinely check and manage your blood sugar levels.
Even with proper management, you’ll still need to take vigilant care of your feet. The following steps may help find and stop a diabetic ulcer before it becomes a problem.
Inspect your feet daily
Check your feet when you wake up or before you go to bed. Look for the following signs of trouble:
If you’re unable to see the bottom of your foot well, use a hand mirror, mirrored scale, or ask for assistance from a partner or loved one.
Don’t try to remove any bumps or calluses
To be safe, avoid any at-home or lifestyle remedies for treating foot problems. This includes over-the-counter wart removers, callus treatments, or blister medication. If you have diabetes, it’s always safer to let your doctor see the problem first.
When it’s time to clip your toenails, you need to take extra care not to cause any skin breaks or tears. Cut the nails flat and use a filing board to remove any sharp spots.
Wash your feet daily
Even if you don’t take a bath, your feet should. Wash and rinse your feet in lukewarm water every day. Dry them thoroughly, but gently. With your doctor’s approval, you can use a pumice stone to gently rub your feet.
If moisture is a problem, you can use talcum powder or cornstarch between your toes to keep the skin dry. A moisturizing lotion or cream may be helpful, but talk with your doctor before you apply it if you have any open sores.
Guard your feet at all times
Don’t walk barefoot. People with diabetes often have the nerve condition neuropathy and don’t experience the same sensation as people without the condition. That means you may injure your foot while barefoot and not know it.
You should also wear clean, dry socks at all times. Fabrics that wick away moisture, such as cotton, are preferred over ones that may make you sweat more, such as nylon or synthetic fabrics.
Wearing proper shoes is important, too. Meet with a specialist that can fit you and find you a proper diabetic shoe, one that’s comfortable but provides plenty of support. Orthopedic shoes that are specifically designed for your feet may be best.
When should I contact a doctor?
Schedule routine foot checkups. Your doctor or podiatrist can inspect your feet and find any potential problems. You can also discuss any issues you’ve been having and find a solution before developing a bigger problem.
Also see your doctor if you hurt, cut, or injure your foot. People with diabetes have to take foot injuries seriously. Because healing is slowed and infections can develop quickly, see your doctor as soon as possible if you injure your foot.
A diabetic boot may not be right for everyone. Speak with your doctor to learn more about diabetic boots and treatment options for diabetic ulcers.