Definition

A disease in which the body cannot produce insulin or cannot use insulin to its full potential. It is characterized by high blood glucose levels.

Causes

• Heredity

• Autoimmune disease

• Drugs such as steroids, Dilantin, and others may elevate the blood sugar through a variety of mechanisms

• Certain syndromes (for example, Prader-Willi, Down's, Progeria, and Turner's) may result in a hyperglycemic state; if this state is prolonged, the result can be permanent diabetes.

Signs & Symptoms

• Flu-like symptoms

• Weight gain or loss

• Blurred vision

• Slow-healing sores or frequent infections

• Nerve damage (neuropathy)

• Red, swollen, tender gums

Orthotic Treatment

As soon as the active stage of the disease is recognized, the patient must be immediately and aggressively protected from excess weight bearing. More agile diabetics with unilateral involvement have done well with crutch-walking on the contralateral foot. As a general rule, forefoot lesions receive less body weight and hence require less protection, a rocker-soled shoe can be used.

Because many of patients already have trouble walking, we prefer not to lock the ankle against plantarflexion unless hindfoot problems exist. A spring dorsiflexion assist is sometimes useful to reduce footslap or aid toe clearance. The rocker sole is individualized since these feet are generally ulcer-free due to the weight bearing restrictions rocker is reduces forefoot pressures.

Complications

• Infections

• Gangrene

• Amputation

Treatment post complication

Due to untreated diabetes amputation usually happens. Depends on the level of amputation, Prosthesis has to be prescribed to patient. Extra care should be taken while giving socket. Material such as Derma seal, silicone can be an option for soft in-liner. Avoid any pressure on the bony sensitive area. Prevent any pain or wound, because healing is very slow in diabetes patient.