Dr. Tessa Busch
Amsterdam UMC (Rehabilitation & Entwicklung Facharzt, Rehabilitation)
Foot ulceration is one of the major health problems for people with diabetes mellitus. It is estimated to affect 19% to 34% of people with diabetes at some time in their lives.  The risk factors for developing a foot ulcer are mainly peripheral neuropathy, peripheral artery disease, foot deformities like pes cavus and claw- hammer toes and previous ulceration or amputation of the foot..  Looking into the problem of the foot deformities, adjusted footwear and offloading are key factors in the treatment. Out of literature we know that custom-made footwear can only be effective in offloading and prevention of ulcer recurrence in high risk diabetic foot patients, if they are made according to the state of the art concept, based on barefoot plantar measurement data and evaluated by inshoe pressure measurements.