Propét Shoes Arrive at Diabetes Awareness Program
There’s a new shoe in town for diabetes patients, and Director of Comanche Nation Diabetes Awareness Gwen Pesewonit said the grant that started the shoe program has been around for 25 years and gets updated every five years.
In this grant, we assist not just Comanche tribal members, but any tribe that lives in the five-county to seven-county area that are a federally recognized tribal member. So, we assist them. They do have to be, number one, a diabetic,” she said. “They also have to seek care either at IHS or one of the local clinics. So, from there we do assist them, too, with their medications. If they're a diabetic, we help them get their insulin, their pen needles, their medications, and then lastly, our shoes. And we also help our diabetic patients with glasses if they need glasses because diabetes can cause blindness.”
The shoe is called Propét, and for the program to receive the shoe, they had to wait for a local stock.
“And sometimes that's not always easy to do. We can look online and pre-order them, but when they go pick them up if they needed them, the store would have to pull them and sell them there in the store. So, it was just a lengthy process,” Pesewonit said. “So, I was like, ‘We got to find something different, something new.’ And I had been over to Medi-Equip before because I got shoes over there myself. So, I was like, ‘Somebody go over there, take a look, see what they got, and we're going to go from there.’”
She said there are a few steps for patients to take before they walk into Lawton Medi-Equipment in Lawton, Oklahoma.
“Right now, we have it, number one, they do have to be a diabetic. They have had to have seen their primary care within the past three to six months. They also have to have a primary podiatrist to make sure there's no ulcers or anything on the feet, no deformities, anything like that. If that happens, we don't assist them here,” Pesewonit said. “They're going to need something else that we can't help with because we keep ours very basic. So, they already have to be established with our program. Then what happens is we set them up an appointment. They see our podiatrist. The podiatrist will give us the clear, ‘OK, they can get shoes.’ If we don't have them here, then we do a voucher to the Lawton Medi-Equip. From there, the pedorthist, which is Mr. Hudson, he goes and he'll look at it. Then he starts calling them, making them appointments for them to come in to get a proper fitting shoe.”
She said diabetics need specially fitted shoes for their feet.
“They have to be a certain, you know, to fit their foot lengthwise, widthwise, because it can cause blisters, it can cause ulcers. And if they have neuropathy, they might not know that's there and it can lead to amputation,” Pesewonit said. “So, we want our clientele to get a proper fitting therapeutic shoe. And through Propét, that's what happens because it meets all that. And we talked with our doctor as well, and he agreed that that would be a good shoe.”
William Smith, a Doctor of Podiatric Medicine, provides foot care and surgery in the state of Oklahoma. He comes to the Comanche Diabetes office twice a week.
“Feet are the most abused part of your body. You walk on them all day, you hurt them, you still have to walk on them. You hurt a hand, you put it in a sling and use the other hand. But you have to use both feet. So, they're always abused. They're always under stress and strain,” he said. “And a lot of times the shoes start to fatigue after a while. You've worn it too long and it starts to break down, the inside of it or the outside of it. As a child, the shoes either outgrow them or you lose them. As adults, we get a pair of shoes, we like them, we wear them, but the inside starts to break down. And so that's when you need to get a different shoe or a shoe with better support. He said the foot was not designed to walk on concrete and other hard surfaces.”
Smith said the foot was not designed to walk on concrete and other hard surfaces; even under carpeting, there’s still concrete.
He said there are certain qualities a diabetic shoe has to have before they give it to patients.
“Shoes have to be lightweight. You don't want a shoe that's two or three pounds, because at the end of the day, you'll be tired and you'll fall. Nobody wants to fall,” Smith said. “So, what we're looking for is we're looking for a shoe that's long enough and wide enough, yet sturdy enough to hold their foot up. We want to have the shoe come up to their foot and select instead of letting their foot fall to the floor. So, you need to have a good cushion in the heel. You need to have support underneath the arch. You need to have a cushion across the ball of the foot. You need to have it wide enough so that it doesn't squeeze the foot and long enough so that it doesn't pinch the end of the toe. Yet the toe box has to be tall enough so it doesn't push down on the top of the toes and cause friction there.”
He has been involved with the program for seven years and said the main aspect of it is education.
“We talk to them about their medication, talk to them about their diet and their exercise. The shoes fall into the exercise part of the framework,” Smith said. “So, what we want to do is when they are looking for a shoe, we want to find something that's going to give them support so that they can walk and ambulate to cut down on their blood sugar. Now the thing is, is, taking their medication and watching their diet is great, but they need exercise, too. And that's where this shoe program helps us because it gives them the proper basis so they can get up and be ambulatory. Even if they've got health issues, arthritis things, this is going to help give them the support they need.”
He said he’s used the shoe for several years.
“In private practice and the representative would always come by and we would order them for all of our diabetics that we could in our private practice,” Smith said. “And now that we're able to join up over here at the Comanche Diabetic Clinic, it's just a win-win situation.”
The diabetes program is also there to help with preventive care for those with diabetes.
“Number one is see your primary care physician. If you're a diabetic, there's a whole new thing that comes with diabetes. It affects your eyes. It affects your kidneys. It affects your feet. It affects your teeth,” Pesewonit said.“If we can get them in before all those things start happening and they start having all these other issues, then they can start walking. They can choose to eat healthier. So, there's the community needs to be involved. If you have a diabetic family member, work with them and say, ‘Hey, let me help you get better.’ You know, ‘Let's go walk.’ ‘Let's go…to the gym for 20 minutes, 10 minutes,’ however long you can go. But it depends on the family. The family has to be the support system. They also have to have a good medical team behind them.”
The Propét shoes were made available to patients about two months ago.
Comanche Nation Diabetes Awareness is located at 5 SW D Avenue in Lawton, Oklahoma and Lawton Medi-Equipment is located at 924 NW 38th Street.
