With diabetes, picking the right shoe matters
For those of us with diabetes, having a very comfortable shoe is not a luxury, it's a necessity. Since diabetes can damage the nerves and blood vessels in your feet, the best possible shoe becomes even more important. To avoid blisters, ulcers and other wounds that could lead to serious complications, take your time in choosing the shoes that suit both your lifestyle and health needs.
Why selecting the right shoe is important
"Pressure and neuropathy along with the possibility of foot deformities can lead to ulceration," notes Dr. Han Pham Hulen, medical director at Medical City Dallas Wound Care in Texas. Relieving the pressure and protecting the foot from injury are two of the ways that the right shoe can help ensure a lower rate of complications.
If you have signs of diabetic neuropathy or foot deformities, your doctor might want you to wear a certain shoe. "Diabetic shoes can come ready-made or customized," Dr. Hulen points out. "I recommend a good shoe that would not cause pressure, such as a diabetic shoe with a wide toe box. A well-made customized insert may also be useful to minimize plantar foot ulcerations and protect the foot."
Finding the right shoes: pedorthists can help
As the executive vice-president and co-founder of the Save a Leg, Save a Life Foundation, De Anna Bell has seen her fair share of patients with diabetes foot problems. As a result, she is quite familiar with the process of finding the right shoe.
"As wound care providers, we work closely with pedorthists," Bell says. "A pedorthist will properly measure the patient's feet and recommend either off the shelf diabetic shoes, or will take a mold of the patient's feet and have the shoes custom-made. Many insurance companies will cover and reimburse for diabetic/therapeutic shoes and three pairs of custom molded inserts annually under the Therapeutic Shoe Bill. The pedorthist can assist the patient with obtaining insurance authorization or determining if the patient's insurance covers the shoes and inserts."
The National Institutes of Health offer the following guidelines to find shoes that are easier on your feet:
- Wear shoes made of canvas, leather or suede. These materials allow your skin to breathe in a way that plastic shoes simply do not.
- Never wear thong sandals. The pressure points can lead to breakdown of the skin over time.
- Wear shoes that are easily adjustable, such as those with laces or buckles.
- Avoid shoes with pointed or open toes, as these can lead to foot injury.
- Make sure your shoes have plenty of room in them. Do not buy shoes with the intention of "breaking them in" to fit.
Foot problems are one of the most common complications of diabetes, and without proper intervention, the consequences can be devastating. The right shoe is a huge step toward making certain that your feet are healthy for years to come.
Medline Plus, "Diabetes Foot Care"
Interview with Dr. Han Pham Hulen
Interview with De Anna Bell