DISCUSSION— The provision of
proper footwear is a cornerstone of any
ulcer prevention program. Patients with
severely deformed feet require custommolded
shoes (6-8), and patients with
minor foot deformities may benefit from
using athletic shoes (3,8). Other patients
at high risk may benefit from wearing special
shoes, while not requiring expensive
custom-made shoes. Some companies
have marketed shoes for diabetic patients,
but there are no comparative data establishing
their absolute or relative efficacy.
Our study indicates the efficacy of
manufactured shoes with customized insoles
in preventing reulceration in a
group of patients at similar risk. In previous
works, the ulcer relapse rate reported
using customized shoes (6,7) is more or
less similar to that obtained in our experience
with manufactured shoes that cost
five times less. The availability of therapeutic
footwear at low cost may contribute
to its diffusion.