Solving the Problem of Treating Diabetic Neuropathy
Being able to walk is something that all of us who have diabetes take for granted, at least until something makes it hard to do or even impossible. That something is often neuropathy, probably the most common complication of diabetes. But new treatments can prevent serious problems.
About 12 percent of us have neuropathy when we learn that we have diabetes, according to the Centers for Disease Control and Prevention at The Prevention and Treatment of Complications of Diabetes Mellitus. This U.S. government organization goes on to say that about 60 percent of us will have neuropathy after 25 years of living with diabetes.
The good news is that neuropathy isn’t inevitable, and the way to prevent it is clear, although not always easy. That way is to keep our blood sugar level normal, especially when our body gives us a warning.
That warning is often a foot ulcer. That was the way a friend of mine, Wayne Coggins, learned that he had diabetes. When I asked Wayne how he would describe himself, he replied, “I am pastor, counselor, and author ... and newly discovered diabetic.” He founded Cornerstone Family Ministries in Kenai, Alaska, and wrote Adventures of an Alaskan Preacher.
His food ulcer required him to wear a “boot,” which is a sort of a cast, on his right leg for more than six months until the ulcer finally healed. This treatment worked, but it came with another problem.
“For several months after I started wearing the boot I was experiencing lower back discomfort and tightness,” Wayne says. The problem was that the treatment essentially made one leg longer than the other.
This is the Evenup -- But Not Wayne's Legs
Just at that time, Wayne’s wife, Marveen, was visiting friends in Colorado and we went for a hike together. On the trail I mentioned to her that I had just heard about something made for exactly this problem, the Evenup Shoelift Device.
They got one. “While it took a bit of adjusting to the extra half inch of elevation it gave my left foot,” Wayne tells me, “the tightness in my lower back stopped as soon as I began using the Evenup lift.”
The Evenup lift works and may be the best known device to rebalance our feet when we have to wear a boot. But several other companies make similar devices, according to my podiatrist, Dr. John S. Jacimiak. I interviewed him recently during one of my regular visits to his office.
“More than a half dozen companies make versions similar to the Evenup,” Dr. John says. “I don’t find any of them to be particularly better than the others. Most of the time I go by price.”
I asked him which one was the least expensive. “It changes all the time, because it depends on who is running the specials.”
Will the patient’s insurance cover the cost? “Virtually never, and that is why we try to go with whatever is cheapest. We can pick these things up for about $15, so typically the patient would pay $20 or $25.”
These devices are probably never going to make our feet perfectly even, Dr. John says, because whatever shoe you put inside of it could have a different tread height. But they do work to solve the problem caused by treating a foot ulcer.