[Protective special shoes for diabetics. Personal experience with a group of high risk diabetics during a 2 and 1/2 year period].

A group of 60 type II diabetics with the risk of development of ulceration of the feet was provided with protective specialized footwear. In the course of 2.5 years in 45 patients who could be evaluated the frequency of relapses of previous ulcerations, the development of first ulcerations and the effect on indicators of immediate high risk of a defect (formation of decubital ulcers, blisters) was investigated, as well as the general biomechanical comfort. In 10 patients with relapsing defects relapses developed twice (20%), no primary ulceration developed. As compared with common footwear, the protective footwear had a favourable effect on the formation of sores and blisters 25 patients (55.5%/ 45/100%) reported improvement of the general comfort when walking. 28 (62.2%) patients make use of the favourable experience with the specialized footwear when selecting shoes or when modifiying standard footwear. A surprising finding was delayed fatigue when walking reported by 35 (77.8%) patients, mitigation of dysaesthesias by 23 (51%), pain in the joints by 14 (31.1%), improved stability by 35 (77.8%) of the patients. With regard of the improvement of some subjective complaints the use of protective footwear can be considered a symptomatic-therapeutic element. According to clinical results specialized footwear has a favourable and protective effect on already damaged feet with a reduced tolerance for combined (mechanical, ischaemic, neurotrophic, infectious) insults. Consistent with data of authors from abroad after a 2-5-year follow-up there was a cca 50% reduction in the number of relapses of ulcerations and amputations as compared with common not modified footwear.