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The number of lower-limb amputations related to diabetes complications is growing-there were 86,000 such amputations in 1999 alone-according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
In what is arguably Medicare's best-kept secret, the healthcare agency offers a specialized shoe program to help prevent complica-tions for people with diabetes and those with foot problems.
Called the Therapeutic Shoe Program, it offers patients in need one pair of customized shoes every year, two sets of inserts and a fitting by a podiatrist or shoe specialist. Patients have the option of ordering either a molded shoe or a depth shoe. In both cases, the shoe is designed to prevent pressure on the balls of the patients' feet.
"The number one reason people go to the hospital for diabetes is foot-related complications," said Sean Tunis, MD, MSc, director of Medicare's coverage and analysis group, in a June 26 New York Times article.
He told the Times that people with diabetes should have their feet inspected regularly. To encourage them to do so, Medicare recently ex-panded its coverage allowing patients who have lost some feeling in their feet to get two foot exams per year.
The program, launched in 1993, spent $54 million to provide 1.25 million pairs of shoes to patients in the year 2000, according to the Times article.