Prescription insoles and footwear

Current research emphasizes the importance of prevention in caring for the diabetic foot. Prescription footwear has been shown to be a significant factor in prevention of both ulcer recurrence and amputation. In addition, scientific evidence demonstrates the ability of insole materials to reduce shock and shear, the effectiveness of insoles in providing pressure relief, and the ability of rocker soles to relieve metatarsal pressure. This evidence, however, is limited and is often based on clinical investigation rather than on objective, quantitative measurements. Recent advances in biomechanical modeling and in-shoe pressure measurement should allow more objective data on a wider variety of prescription footwear to become available. The importance of prescription footwear as a preventive measure is nonetheless widely recognized. The knowledge and experience of pedorthists make them uniquely qualified to provide the needed shoes, modifications, and insoles for the long-term management of the diabetic foot.