Diabetes Mellitus

What is Diabetes Mellitus?

How Does Diabetes Affect the Body?

Diabetes Mellitus is a chronic (long-term) condition that results when the body is not able to control the amount of glucose (sugar) in the blood. In Type I diabetes, also known as juvenile or insulin dependent diabetes, the pancreas does not produce enough of the hormone insulin. Insulin is essential to for glucose regulation in the blood and to transport glucose into the cells to be used as energy.

When the pancreas does not produce insulin or enough insulin, the cells do not have enough energy to function properly and the amount of glucose in the blood builds up.

In Type II diabetes, or adult onset or non-insulin dependent diabetes, the pancreas may be producing plenty of insulin, but the cells of the body are not able to use insulin properly to transport sugar into the cell. Again the level of glucose in the blood rises. 

Too much glucose in the blood can cause damage to nerves, kidneys, eyes and other organs.  Out Certified Orthotists treat many different issues such as foot ulcers and foot drop that are a result of high blood glucose.  Please see below for more details.

Diabetes Mellitus pathology
How does this relate to orthotics?

We help manage the complications of diabetes

Many of the people we see at Custom Orthotic Design Group Ltd. have diabetes and are in fact, referred to us to treat and help manage the complications of diabetes.

The high levels of sugar in the body cause damage to the nerves of the body. There are many different types of nerves in our bodies including motor, sensory and autonomic.

  • Motor nerves send messages to the muscles to cause movement such as walking or wiggling a toe.  Loss of motor nerves can cause muscle weakness and result in problems such as foot drop.
  • Sensory nerves tell us if something is touching or hurting us and where our body parts are in relation to each other (proprioception).  Loss of sensation includes the loss of protective sensation.  If that happens and someone steps on a sharp object, they might not know they have and might not treat it properly.
  • Autonomic nerves are responsible for changes to our blood flow, temperature causing us to blush and sweat.  With now sweat, feet can become very dry and cracked, allowing bacteria to enter the body.


When any of the nerves are impaired (neuropathy), our body does not work as it is supposed to and there is a potential for complications.

Diabetic Foot Ulcer, Foot Drop, Charcot foot


Treatment depends on the requirements of the individual but the focus is on support and protection of feet for people with diabetes.  Some of the complications of diabetes may be:

Foot drop → ankle foot orthoses

Deformities → foot orthoses, orthopaedic shoes, ankle foot orthoses

Loss of protective sensation → foot orthoses, orthopaedic shoes

Poor balance → foot orthoses, orthopaedic shoes, ankle foot orthoses

Ulcer → Offloading, foot orthoses, orthopaedic shoes, ankle foot orthoses, CROW walker, removable cast walker

Charcot arthropathy → CROW walker, removable cast walker, foot orthoses, orthopaedic shoes, ankle foot orthoses

To learn more about Best Practices for Prevention and Management of diabetic foot ulcers please go to:

BEST PRACTICE RECOMMENDATIONS FOR THE Prevention and Management of Diabetic Foot Ulcers 

To learn more about caring for your feet if you have diabetes, please go to the brochure, Diabetes, Healthy Feet and You by Wounds Canada:

Our Treatment Options

Treatment depends on the requirements of the individual. Some options may be:

Ankle Foot Orthosis

An AFO can prevent foot drop and improve your balance for walking.

This image shows someone putting a rigid AFO on a person.

Orthopaedic Shoes

Proper fitting shoes can prevent pressure on your foot deformities and allow room for swelling. 

Foot Orthoses

Custom foot orthoses protect your foot from damaging pressures to prevent calluses and ulcers.

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