5 Medicare-Covered Professionals You Need on Your Diabetes Treatment Team

Diabetes management plans often include many different elements: monitoring blood pressure, adjusting diet, and protecting feet to name a few.

Medicare and most insurance plans respond to these needs by covering health services for people with diabetes. Combined with coverage for medical equipment (such as diabetic shoes) and medications, regular appointments with these professionals can make a big difference for diabetes management. Here are the 5 professionals that are worth adding to any diabetes care plan.

1) Your family doctor (MD).

family doctor diabetes blood pressure medicare

We started with this professional because they are the absolute foundation of any diabetes treatment plan. According to Cleveland Clinic, insulin-dependent people with diabetes should see their doctors at least once every 3-4 months, while once every 5-6 months will usually suffice for those treated by pills.

Making the most of these appointments is critical. Something that seems small, such as mild foot pain or lower stamina, could be serious when diabetes is involved. To ensure your bases are covered, provide your doctor with all detailed information they may need at each appointment. This includes recent glucose readings, dietary or exercise changes, and reports of any pain or health challenges (however mild they may seem).

If your doctor recommends any durable medical equipment to help with your diabetes management, such as diabetic shoes or a continuous glucose monitor, be sure to ask them about what paperwork you will need to submit for Medicare coverage. Suppliers like nocostshoes.com can also fax the necessary forms to your doctor prior to ordering, but it can help to bring this up at appointments as well.

2) An optometrist/ophthamologist

ophthalmologist doing an eye test for diabetic retinopathy

To understand why seeing an eye care specialist is important, look no further than the statistics on diabetes and eye disease. Diabetic retinopathy is the leading cause of blindness in U.S. adults. As of 2010, 7.69 million Americans had reported a case of diabetic retinopathy, a number which continues to steadily increase each year.

The functioning of eyes is greatly affected by the functioning of blood vessels – in fact, it is not uncommon for an optometrist to identify the first symptoms of diabetes. For this reason, Medicare covers annual diabetic retinopathy exams. Making and keeping these appointments is important in protecting eyesight for individuals who have diabetes.

3) A podiatrist.

podiatrist checking diabetic patient's feet

Serious foot issues and amputation is one of the lesser-known risks of diabetes, though ignoring it can lead to devastating consequences. With diabetic neuropathy, even small foot injuries can become quite serious over time.

To prevent these extreme consequences, Medicare extends coverage for a foot exam once every six months to those with diabetes-related nerve damage. In addition, Medicare often covers diabetic shoes through nocostshoes.com for qualifying individuals. This care protects feet as well as improving your comfort and quality of life as you move through your day.

4) Diabetic Self-Management Training (DSMT)

Managing diabetes often requires significant life changes. Many of these changes must be managed by the individual with the diagnosis, which is why Diabetic Self- Management Training is such an important tool.

In the first year, Medicare may cover up to one hour of individual training and up to nine hours of group training. Following that, 2 hours of follow-up training per year may be covered. This training must be conducted by a certified individual and be deemed necessary by your doctor in order for coverage to be offered. Fortunately, most doctors will deem DSMT a necessary service for their patients, especially those who struggle with some aspects of adapting to life with diabetes. The one-on-one training option is particularly helpful for those struggling with particular aspects of diabetes management.

5) A registered dietician.

registered dietician diabetes
Doctor Giving Advice On Healthy Diet

Along with diabetic self-management training, a dietician can help people understand how best to adapt their diet following a diabetes diagnosis. Since food is such an important aspect of diabetes management, Medicare has extended additional coverage to help those who need a registered dietician as they transition into this new lifestyle.

Depending on what is deemed “medically necessary” by your family doctor, this coverage could entitle you to a  nutrition and lifestyle assessment, individual support and/or group nutrition therapy services, and follow-up appointments. A dietician can clarify the best eating choices for your health and educate you on proper nutrition to improve your health going forward.

Need more support? Proper communication with your family doctor is the key.

There are many different health care services and equipment that can help you to manage diabetes. Medicare or insurance coverage of these things is often contingent on your doctor filling out a Certificate of Medical Necessity. To determine what is medically required for your care, they need to have all the information in front of them.

So, if you are struggling with diabetes self-care, eating changes, or foot/eye issues, be honest and let your doctor know! There are many things they can do to help you access additional care.

For information on diabetic shoes and durable medical equipment covered by Medicare, visit nocostshoes.com.

buy diabetic shoes - all shoes are on sale

Picking the Right Shoes for Swollen Feet (Edema)

Swollen feet or edema can be extremely uncomfortable, especially for people who don’t have the right shoes. Luckily, therapeutic shoes specifically for individuals with swollen feet are available on the market right now. For those who are dealing with this issue as a result of diabetes, these specialty shoes are often covered by Medicare. Here is some information every person dealing with edema should know about caring for their feet.

What causes edema/swollen feet?

If you have swollen feet, chances are the issue stems from a buildup of fluid. Excess fluid will leak into tissues in and around the feet, causing swelling.

There are many reasons this can happen. For example, pregnant women often deal with edema because they retain more fluid before giving birth. Medications can also set off edema, particularly those which impact blood vessels. It’s important for people to talk to their doctor about the reason they are dealing with swollen feet, as this can be a symptom of heart, kidney, or liver issues as well.

People with diabetes are prone to edema for several reason. Firstly, diabetes medications like Actos and Avandia can impact the heart and bloodstream, which may cause blood vessels to leak fluid. Circulation and co-morbid heart issues are also a factor in not only causing swollen feet but also making it difficult to treat the issue. This is what makes finding the right shoes so essential for people with edema, especially when combined with diabetes, heart disease, or circulation issues.

Why you should wear diabetic shoes for swollen feet (even if you don’t have diabetes)

Therapeutic shoes designed for people with diabetes are a good fit for people with edema, even if they personally do not have diabetes themselves. The diabetic shoe market is very established, primarily because most insurance plans (including Medicare) cover the annual purchase of a pair as well as 3 sets of inserts.

If you do have diabetes, this can mean your shoes will be low or no cost! If you do not, you can still benefit from the enormous strides in diabetic shoe technology to manage your edema.

When picking shoes for swollen feet, you should seek a pair that has the following qualities:

  • Extra width to accomodate the swollen foot;
  • Stretchable and durable material;
  • Increased stability – inserts can be used to help with this as well;
  • Fitted by a professional (you can get a shoe fitter house visit through nocostshoes.com); and
  • A reliable, accredited brand recognized by podiatrists and Medicare.

Our Bestselling Women’s Shoes for Swollen Feet

Annie X from Dr. Comfort

Dr. Comfort is one of the most trusted therapeutic shoe brands on the market today. Among its wide selection you’ll find this Annie X shoe, which includes comfortable extra depth, gel inserts and a convenient velcro fastener. Designed with comfort in mind, it’s a great choice for people dealing with edema and other foot issues.

Velcro shoes from New Balance (available in beige, white and black)

Another shoe that comes with velcro convenience, these shoes are truly made for walking – even if you’re managing a foot issue. The high quality soles and custom fit make it easier to move around if you’re dealing with edema, making New Balance shoes a popular choice. Don’t like the velcro? Laces are also available for those who prefer!

Slip On Dress Shoes from Orthofeet

Need some edema-friendly shoes that fit more formal workplaces and occasions? Slip ons are a great choice in this case. Our shoe fitters will make sure this pair from Orthofeet are sized just right, so you can get them on painlessly and still enjoy a secure fit. The therapeutic inside of the shoe is smooth and comfortable, preventing blisters and keeping your feet safe as they heal.

Where can I purchase therapeutic shoes for swollen feet and how much do they cost?

Many people are eager to support their swollen feet, but aren’t sure where to start. For the best rates on therapeutic shoes, recommend purchasing shoes from a Medicare-approved supplier like No Cost Shoes.

Medicare-approved suppliers tend to have a higher inventory of shoes so they can offer better prices and selection. For example, right now all our shoes are on sale for $99. This is significantly lower than the cost at a storefront or even an individual brand’s website.

Medicare-approved suppliers like No Cost Shoes can also send a qualified shoe fitter to your home and help with any insurance claims as needed.

12 Signs It’s Time to See a Podiatrist

Podiatrists are doctors who specialize in feet, ankles, and related structures in the leg. They help people who have issues such as dry heels, ankle pain, toe issues or other challenges related to their feet. For people with diabetes, the stakes are higher – podiatrists are a critical part of any diabetic treatment team, and knowing when to visit them can make a big difference in someone’s overall health.

No Cost Shoes is a supplier of therapeutic and diabetic shoes across the U.S., so we get questions about this a lot: “Why do I need a podiatrist?”, “How often should diabetics and non-diabetics get their feet checked?” and, of course, “What will my insurance cover?”

We think this information is important for anyone to have handy. So, we’ve developed this helpful list of 12 signs it’s time to see a podiatrist. This information can benefit everyone, though people with diabetes will find it particularly critical to follow.

1) It’s the doctor’s orders.

People often first mention foot issues to their family doctor, since this is the medical professional they see most regularly. Oftentimes, this physician will provide a referral to a podiatrist when patients bring up their feet. Like any medical referral, it’s important to follow it and see the recommended specialist.

Note: Individuals with diabetes should also speak with their physicians about filling out a Certificate of Medical Necessity (CMN) to access Medicare-covered therapeutic shoes and inserts. Click here to read the full process for getting diabetic shoes and other aids covered by Medicare.

2) Certain types of swelling.

It is not unusual for feet to swell after some activity. In fact, just about everyone’s feet are bigger later in the day due to natural swelling (this is why we recommend getting a shoe fitting in the afternoon, rather than the morning). However, some types of swelling are cause for concern. For example:

  • Swelling in just one foot;
  • Swelling that is extreme, especially if there is also pain;
  • Swelling that is persistent and doesn’t go down.

This kind of swelling can indicate an injury, blood clot, heart/circulation problems, or kidney issues. A visit to your family doctor or podiatrist is a good idea in these cases.

3) Unexplainable pain and/or numbness in one or both feet.

foot pain diabetes why to see a podiatrist

Numbness and pain in feet can be a sign of neuropathy. Many find this pain particularly flares up at night or in the morning. Those experiencing unfamiliar pains or numbness should speak to a podiatrist right away.

4) A blister, ulcer or sore that won’t go away.

A small blister is usually not cause for concern in most people. However, those with diabetes in particular may find that a small sore can turn into a large ulcer without proper care. The main signs of serious foot ulcers include black tissue or gangrene around the wound.

Keep an eye out for discoloration around a wound (especially dark colors), pain near the area, or sign of infection. Anything unusual such as this should be looked at by a professional right away, especially if diabetes is involved. Depending on the situation, your doctor or podiatrist might request an immediate appointment to look at any abnormalities, as tiny blisters can become serious problems rather quickly for someone with diabetes.

5) Thick corns or calluses.

Corns and calluses can be extremely uncomfortable, and often the right pair of therapeutic inserts or shoes can help soften the issue. A podiatrist will be able to examine the corns and recommend the best treatment options.

6) Split skin and heel dryness.

cracking skin dry heels diabetic feet

Dry skin is a common challenge for many people, but can be particularly prevalent in those with diabetes. Therapeutic inserts and shoes recommended by a podiatrist can make a big difference here.

7) Bruising or discoloration on the feet.

It can be quite a shock to see bruising on one or both feet, particularly if you don’t remember any injury taking place. Sometimes, people with peripheral neuropathy can get a foot injury without knowing it – even broken bones might fly under the radar for numb feet! Bruising and discoloration certainly warrant a trip to the podiatrist, especially if the cause of the issue is unknown.

8) Toe issues like ingrown toes or hammertoes

Ingrown toenails, hammertoes and other issues with toes are all things a podiatrist should look into, particularly if toes are causing pain or making it difficult to walk. Any diabetic with such issues should see a podiatrist right away, as the combination of hammertoes and circulation issues can lead to infections and ulcers. Luckily, therapeutic shoes and inserts can often help minimize these risks.

9) Starting a new exercise plan (in some cases).

No, we’re not saying that you need to see a podiatrist every time you plan to go to the gym. However, they should be consulted in certain cases:

  • If it will be intensive for your feet, such as training for a marathon;
  • If you have diabetes, particularly if you have had foot issues in the past;
  • If you need special shoes or inserts to support your new regimen;
  • If you have had a foot injury, surgery or challenge in the past and need to be cleared for the new venture.

10) Needing advice, fittings or a prescription for therapeutic shoes.

Anyone can buy therapeutic shoes without a prescription, however a podiatrist can be very helpful in clarifying what type of shoes a person needs. They can also write a prescription for shoes to help people qualify for insurance coverage, as Medicare and most insurers cover shoes for certain diabetic patients.

Along with a prescription and Certificate of Medical Necessity, Medicare and most insurers also require therapeutic shoes to be properly fitted before providing coverage. This will ensure shoes and inserts are perfectly customized to a person’s feet, making them far more comfortable and effective. Shoe fittings can often be done at a podiatrist’s office, as well as through an in-home visit from a shoe fitter. Click here to read all the options available for diabetic shoe fittings.

11) Difficulty adjusting to new shoes.

Podiatrists can offer specific instructions for “breaking in” new shoes (especially therapeutic shoes) without risking an injury, blister or other issues. This advice can be extremely valuable, so make sure to call a specialist if new shoes are giving you trouble. Trying to just “push through” can cause damage, especially in those with pre-existing conditions.

12) Insurance/Medicare covers your visit.

Why visit a podiatrist? Well, for many people the question is “why not?”!

Annual podiatrist visits are covered by Medicare for people with diabetes. Others may have the specialist paid for at least in part by a group insurance plan. Check to see if you are covered – if you are, it’s a worthwhile visit to mark on your calendar.

17 Creative Ways to Care for Diabetes

When most people think about how to care for diabetes, the words “creative” or “easy” probably don’t come to mind. It’s time to change that.

In this article, we go beyond the typical advice of “eat better!” and “check your blood sugar!” to offer super-specific tips on how to manage your own diabetes and/or how to care for a diabetic loved one. From free therapeutic shoes to hacks for remembering medications,  here are 17 super-helpful ways to keep diabetes under control.

  1. Do some meal preparation. Healthy eating is critical to diabetes management. Save time and make the diet shift easier by setting aside a few hours each week to prepare food for the coming days.
  2. Go to the Farmer’s Market. People with diabetes should eat lots of fruits and vegetables. What better place to find these items than your local market? Shopping at a local Market can get you on your feet and put fresh produce in your fridge. Win-win! For tips on what to get (and what to avoid) at the Farmer’s Market tips, this article offers some great pointers.
  3. Use free resources to educate yourself on sugars and carbohydrates. The best way to do this is through Medicare-covered Diabetes self-management training. You can also find fact sheets on these topics by reading our article on the Best Free Resources for People with Diabetes.
  4. Create a system for recording blood sugar (glucose) readings. Whether you use an app on your phone, enjoy the convenience of a Continuous Glucose Monitor, or simply keep a written log, make sure you have a way to share recent numbers with your family doctor.
  5. Organize medications by day. When you keep all your medications in the large generic containers used by most pharmacies,
    daily weekly pill box diabetes medications
    Source

    it can be difficult to remember whether you took your pills for the day. Make it easier by purchasing a day-by-day pillbox at the local pharmacy or dollar store.

     

  6. Set a reminder to take medications using an alarm or a smart pillbox. Missing medications can be a big risk to your health. Using an alarm or Smart Pillbox is a good way to make sure you stay on track with your medical plan.
  7. Wear diabetic shoes. If you have diabetes, you are
    at higher risk for foot complications and infections. That’s why Medicare covers one pair of diabetic shoes and three pairs of therapeutic inserts for people with diabetes and foot complications each year. Want to find great shoes that are covered by Medicare? Click here or on the image below to order your FREE color catalog
    .
  8. Check your feet for cuts, blisters, red marks, swelling and other issues each day. Diabetic neuropathy may prevent you from feeling foot injuries, so take some time each day to look over your feet. If you can’t bend over to take a look, have someone else inspect your feet for you. Make an appointment with your podiatrist if something is amiss.
  9. Keep medications close to the kitchen to coordinate mealtime with medication time.  Many diabetes medications should be taken on a full stomach, so it’s a good idea to keep your pills on hand after lunch and dinner. It’s a good idea to create a healthy routine of eating good meals and taking medications around the same time each day.
  10. Prepare for special occasions and celebrations involving food. That Fourth of July BBQ won’t negatively impact your health if you show up with some sugar-smart alternatives!
  11. Go to the optometrist once per year (make sure you are also tested for glaucoma!). Medicare covers one eye exam and glaucoma test for adults with diabetes each year. Booking a regular appointment is a must to protect your sight from diabetes complications.
  12. Stay hydrated with water, not sugary drinks. Much of the sugar we consume each day is in the form of beverages, including soda, juice, and alcohol. Drinking lots of water will reduce your cravings for these items, helping you to manage your health.
  13. Get regular exercise, even if it’s just a walk each day.  Regular exercise is an important part of most treatment plans, but it doesn’t have be complex! Make walking around town or on a nearby trail a regular part of your day, or find an exercise class that you really enjoy. Working this into your normal schedule is a great way to support your health!
  14. Communicate openly with your doctor. Many health concerns that may seem “small” or unimportant, like blurry vision or a foot blister, can be a much bigger deal when combined with diabetes. It’s best to tell your doctor everything you can about your health – open communication can save your life.
  15. Store insulin properly. Insulin is an important part of most treatment plans, but failing to store it properly can render it useless. Make sure insulin is kept in a temperature controlled area and that it is not used after its expiry date.
  16. Set a reminder to brush and floss your teeth twice each day. People with diabetes are more likely to get infections in their teeth and gums. Care for the health of your mouth with regular brushing and flossing. A visit to the dentist is also a good idea.
  17. Take up a relaxing hobby and lower your stress levels. Diabetes and stress is a bad combination for your blood pressure and heart health.  Take time to garden, read a book, listen to relaxing music – whatever you enjoy most! This will help you to relax and keep your stress levels under control.

Going to the Gym with Diabetes? 6 Critical Tips about Exercise for Diabetics

Just like a healthy diet, exercise can help people to manage diabetes. Medical professionals tend to agree on this fact, but coming up with a fitness plan can be confusing; some experts encourage regular workouts while others caution against intense movement.

At No Cost Shoes, we get a lot of questions from diabetics hoping to get on their feet in a healthy, sustainable way. Here the six most critical tips to consider as you strive for a more active lifestyle.

Note: This article is a collection of general, helpful tips and should not replace professional medical advice. Talk to your doctor before starting any exercise plan.

1. Check your heart health first.

blood pressure testing diabetes

People who are diagnosed with Type 2 diabetes often have other co-existing health challenges, such as obesity, high blood pressure, or heart conditions. While exercise may help control diabetes, starting a rigorous fitness program without considering these other conditions would be a mistake.

For example, while exercise is generally a good move for heart health, working out too vigorously at first can cause issues. It is particularly important to chat with a doctor if you have blocked arteries or high blood pressure, as these conditions can be impacted by physical activity.

2. Always keep a 15 g carb snack with you – and don’t forget the water!

As a diabetic, it’s a good idea to stay hydrated and keep a low blood glucose treatment handy at all times. That advice is even more critical when you’re exercising. A 15g carb snack, like a granola bar, can serve as a necessary source of glucose in a pinch. This tip is particularly critical when you’re working out where food may not be readily available – for example, when you go on a wilderness hike.

3. Record your progress.

tracking fitness for diabeticsThe more information you can provide to your doctor, the better. A record of what you’re doing will help a medical professional understand the progress you’re making and how your fitness plan is affecting your overall health. If writing everything down seems tedious, consider investing in a fitness tracker. These high-tech watches can keep an eye on steps, heart rate, movement goals and more – all information your doctor might find useful at your next check-up.

4. See the right professional.

While your family doctor might be great at diagnosing issues and prescribing medication, he or she may not be particularly experienced with diabetic fitness (after all, no one is an expert in everything!). Consider working with an exercise physiologist or a personal trainer with diabetic knowledge to get started in the right direction. An expert can show you which exercises to focus on, how hard to work, and even how to make fitness fun! If you’re new to exercise, having someone by your side to help out can make a big difference.

5. Test your blood sugar regularly.

testing blood sugarHemoglobin A1C and blood glucose testing are important rituals for any diabetic. For those taking on an exercise plan, testing has an added perk – motivation! Exercise often keeps blood sugar under control, and good test results can bring a sense of encouragement for those taking their first steps into a healthier lifestyle.

6. Take care of your feet and wear the right shoes when exercising.

Diabetes is linked to foot problems for two reasons. First of all, diabetes can cause nerve damage that impacts a foot’s sensitivity to pain – imagine breaking a toe while working out and not even feeling it! Add to this poor circulation issues, and suddenly feet are at major risk for active diabetics.

When working out, take these steps to protect your feet:

  • Pick an exercise plan that is lower risk for your feet. Instead of running on rough terrain, for example, try using an exercise bike or a paved sidewalk.
  • Nerve damage could make it difficult to detect injuries, so be sure to inspect your feet during and after an exercise session. If you fall on, twist, or hit your foot, do not use pain as an indicator of damage. Instead, stay off of the foot for a few hours and have it inspected by a medical professional.
  • Get diabetic shoes that are optimized for activity. Medicare and major insurance companies cover one pair and two inserts per year, so it’s best to replace your shoes every 12 months (it’s free, so why not?). If you’re a resident of the United States and want to see if you’re covered for diabetic shoes, click here.

Staying healthy with diabetes

Staying healthy with diabetes is not a matter of just taking a pill and moving on – lifestyle changes and preventative measures are often a critical part of a treatment plan. Done correctly, exercise can and should be a part of this journey!

Keeping healthy with diabetes doesn’t have to be expensive – while gyms and trainers are amazing support, even a daily walk outside in the right pair of shoes can help support a healthy, happy life.