Insole modification as a plantar pressure distributor in diabetic polyneuropathy

73 years old, male, referred from Internal Medicine department with diagnose Diabetic Polyneuropathy. The patient felt numbness at both feet since about 8 ago and also complain shortened walking distance because of fatigue. From the physical examination we found that has muscle weakness left leg. foot there were decreased vibration light touch sensation, anhidrosis, hyperkeratosis his feet. There charcot arthropathy fat pad. Foot pressure was high. treatment goal for this is to wear comfortable footwear, improving endurance, preventing future ulceration. insole needed decrease plantar during ambulation. Recommended rehabilitation involves interaction between health care team achieve goals.