Diabetes is a Modern Epidemic.

The global incidence of diabetes, especially Type 2, is increasing and is of major concern to patients, governments and health care providers. There have been many significant advances in diagnosis and therapy but these are not preventing the vascular and neurological complications of the disease.

Patients with diabetes are advised to take medication, reduce their caloric intake and be more physically active.  Stimulation of metabolic activity by way of exercise is the best way to achieve healthy carbohydrate metabolism.
The effectiveness of dietary restriction is limited by our physiological response of reducing metabolic activity in response to caloric restriction. Patients are advised to exercise regularly to reduce their weight and stimulate their metabolism but this advice is often ineffective because of our modern lifestyle and also because people generally develop lower extremity overuse injuries when they become more physically active.

Homo Erectus, our distant ancestor, lived on the earth over 2 million years ago. Homo Sapiens evolved almost 1 million years ago and is the direct precursor of modern man. These genetic ancestors were extremely well adapted to their natural environment and were effective hunter-gatherers. Bipedal gait and the development of the opposable thumb enabled man to manipulate and change the environment. The 1st major change from the natural hunter-gatherer lifestyle was the development of agriculture and the domestication of animals about ten thousand years ago. The changes to our environment and lifestyle have
accelerated since then. The Industrial revolution, 250 years ago, brought about major environmental and social changes and signified the end of man’s natural existence.
Diabetes is a disease of our modern environment. In the environment of the Information Age physical fitness and activity are no longer required for survival. Machines and computers have freed us from having to hunt and gather our food and effective medical therapies enable us to live longer. Infection, trauma and malnutrition, the major causes of death in past times have been replaced by obesity, degeneration, musculoskeletal pain, psychoneurosis, diabetes and other diseases of the modern environment. Some people say we have evolved from Homo Sapiens to Homo Diabeticus.

One of the major differences between the natural and modern environment are the surfaces beneath our feet. Natural environments provide a wide variety of textures, densities and inclinations but our modern walking surfaces are uniformly flat and hard. Adaptation to these unnatural surfaces and also to wearing modern footwear induces dysfunctions in the foot, the leg and the musculoskeletal system as a whole. Modern, flat, hard walking surfaces are bad.

The human foot tries to adapt to flat surfaces by pronation of the subtalar joint. This causes the foot to assume a flattened posture, induces internal rotation of the leg and malalignment of the musculoskeletal system.

The pressure on the sole of the foot is abnormally high under the ball of the foot and the heel. These abnormal pressures cause pain, corns calluses and can result in ulceration if the resilience of the soft tissues is impaired as in diabetes.

Modern surfaces do not stimulate the mechanoreceptors of the foot in a natural way. This adversely affects the neuro-motor function of the lower extremity and makes gait inefficient because of dysfunctional motor patterns.

Modern surfaces to not provide the variety of neural inputs necessary to activate the stabilizing muscles of the lower extremity. Weakness of these stabilisers results in impaired
proprioception, balance and stabiltiy. Hard surfaces induce harmful impact vibrations in structures of the lower extremity and prevent these vibrations from being effectively dampened by the muscles. These vibrations lead to fatigue, pain and degeneration of soft tissue structures. The venous plexus under the arch of the foot is not compressed sufficiently to activate the Venous Foot Pump. This results in venous congestion, swelling of the foot and increased resistance to the inflow of arterial blood. Modern footwear has been shown to induce functional adaptations that decrease the mechanical efficiency of gait, impair natural neuro-motor function and also create abnormal friction and pressure on the soft tissues of the foot. Shoes enclose the foot in an abnormal environment that is hot, sweaty and infectious. This leads to maceration and infection of the soft tissues of the foot. We must pay more attention to the feet.

The significance of optimal foot care for patients with diabetes has been underestimated. Efforts are made to treat and prevent ulcers in patients with impaired sensation and circulation. Patients are advised to keep their feet clean and dry, avoid wearing shoes that are too small, avoid wrinkles in socks and to have “shock absorbing” insoles. However, a great deal more can and should be done to optimize lower extremity function, improve mobility and prevent complications of diabetes. Proper management must begin with the realisation that our modern environment is the cause of stress and dysfunction in the lower extremity. The therapist should assess the function of the foot and lower extremity as a whole as well as the sensation and circulation of the foot. 
Improved foot care has extremely significant effects.

The Foot Science Diabetes Management System The Foot Science Diabetes System combines three essential components for healthy foot and Lower Extremity Function. FORM THOTICS MEDICAL ORTHOTICS The Formthotics™ Medical orthotics provide a model and method of assessing and improving lower extremity function that is based on current scientific information.

The FMS recognizes that dysfunction of the foot and leg is induced by the body’s adaptation to flat, hard and unnatural surfaces under the foot. The 6 Tests™ of the FMS assess function from both a mechanical and neuro-motor perspective and enable the therapist to fit and adjust Formthotics™ Customized foot orthoses to achieve beneficial effects.

The FMS is essential for Diabetes Management. Thermoforming the Formthotics™ to the contours of the sole of the foot in a balanced posture to unload pressure areas, provide optimal custom support and improve the stimulation of the mechanoreceptors in the foot. 
Thermoforming the Formthotics™ in the footwear achieves an elegant functional and natural interface between the body, footwear and hostile modern environment. Total contact with the sole of the foot and effective activation of the Venous Foot Pump to improve the circulation of blood to the foot, reduce swelling and enhance cardiac return.
Adjusting the Formthotics™ with wedges to achieve improved biomechanical alignment, a reduction in the loading on muscles during supination, reduced resistance to forward progression during gait and improvements in balance and forefoot stability. Therapy and prevention for the lower extremity “overuse” problems that prevent patients from exercising regularly to lose weight, stimulate healthy metabolism and better manage diabetes.

HIGH-QUALITY PALADIN NATURAL THERAPEUTIC SOCKS

Paladin technical socks have been designed with the professional advice of one of New Zealand’s leading Podiatrists. Their design, the materials used in them and their method of manufacture enable optimal temperature control, moisture management and infection prevention. The design incorporates areas of varying tension to maintain a snug fit and stop the socks from wrinkling under the foot. There are no seams to cause pressure.
Padding and ventilation regions are strategically placed. The cuff of the sock does not constrict the circulation. Merino wool is comfortable to wear, durable and provides optimal natural insulation from heat and cold to maintain a healthy thermal environment for the foot.
Paladin Socks maintain a healthy environment in the shoe.

Activated Seacel fibre is made with seaweed, which is hydrophilic and helps to “wick” away excessive moisture from the skin. It is impregnated with colloidal silver to help reduce the risk of infection.

MERINO LANOLIN FOOT CREME
Foot Science Merino Crème is an ideal skin care product for the foot. It moisturizes, provides a protective barrier on the skin and has natural antiseptic agents. The application of the crème also encourages the patient to frequently examine and message the feet.

Optimal skin care maintains resilience to prevent infection and ulcers. Conclusion Current efforts to manage the global epidemic of diabetes are impaired by overly emphasising the potential of drugs and diet and under-appreciating the significance of the adverse effects of our modern environment on lifestyle, physical activity and the function of the Lower Extremity.
The Management of Diabetes should be from the foot up rather than from the mouth down.
For more information on the Foot Science Diabetes Management System contact us at:

Foot Science International Limited
26 Dakota Crescent, Sockburn
PO Box 7337, Christchurch
New Zealand
Tel: +6433482115 Fax: +6433480116
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Web: diabetes.formthotics.com