Walk into good diabetes foot care with therapeutic shoes
Choosing proper footwear can help you avoid some of the more feared complications of the disease, including neuropathy, ulcers, infection and amputation. The American Orthopaedic Foot and Ankle Society (AOFAS) recommends therapeutic shoes designed for those with diabetes should do four things:
- Alleviate excessive pressure on the foot
- Reduce shock, or impact, and shear, or the movement of the foot inside the shoe
- Accommodate, stabilize and support the foot, including the foot with deformities
- Limit the motion of joints if necessary
How to choose the right therapeutic shoes
Start by learning what type of shoe, size and fit is correct for your situation. If you are new to diabetes and don't have any problems with your feet, a high-quality shoe that fits correctly and has a shock-absorbing insole might be all you need. If you have any loss of sensation in your feet, a shoe fitting by a podiatrist can help ensure you are getting the right size and fit of shoe.
These guidelines from the AOFAS might help when you head to the shoe store:
- Look for a shoe with ample room around the toes, ball of the foot and instep. There should be a snug fit around the heel.
- The widest part of the foot, at the base of the toes, should also be the widest part of the shoe. Avoid shoes that press your toes together or cause any sort of restriction in this area.
- There should be 3/8 to 1/2 inch between the end of your longest toe and the end of the shoe.
Keep in mind that these tips are for those who can wear an 'off the rack' shoe. If you have deformities of the foot, healing ulcers, loss of sensation, or any other foot problem that could cause issues with typical shoe fit should talk to your doctor about special therapeutic shoes for those with diabetes. Custom-made shoes can be prescribed to accommodate most foot problems.
Does insurance cover diabetic shoes?
In many cases, your health insurance might cover at least one pair of specially-designed shoes per year, assuming that your doctor deems it necessary. Since health coverage can vary from one insurer to another, be sure to check with your insurance provider about their benefits and coverage.
Medicare Part B covers therapeutic shoes and inserts for those who have serious complications of diabetes, which need to be prescribed by your physician or podiatrist. There are very strict guidelines that must be followed, beginning with the doctor's exam and certification that you do need special shoes.
Final points to ponder
No matter what type of shoes you wear, the American Diabetes Association recommends carefully inspecting your footwear every time you put them on. Make sure the lining is smooth, so as to avoid blisters, and make sure there are no objects inside, such as a small piece of gravel or other debris. To avoid ulcers and other damage to your foot, always wear comfortable shoes, even when walking around in your own home.
American Diabetes Association, "Foot Care"
American Orthopaedic Foot & Ankle Society, "Shoes and Orthotics for Diabetics"