Living with Diabetes: What You Need to Know About Footwear

Living with Diabetes: What You Need to Know About Footwear

Diabetes Mellitus is a metabolic disease that affects millions of people worldwide. Prolonged high blood sugar levels can cause a multitude of complications in various parts of the body, and your feet are no exception. Circulation is affected by the unstable blood sugar levels, thus affecting the healing in the extremities. Peripheral neuropathy can eventually occur, which is nerve damage causing loss of sensation. Neuropathy affects the individual’s ability to know when it is injured, which contributes to neglect of any injury on the skin surface that can then lead to ulcers. Hence, it is important to ensure the right footwear is picked out to protect the feet, which we will cover in this article. Poor footwear can trigger severe problems, such as foot ulcers, infection and even amputation.

Diabetic Footwear Features

Fit

• Your shoes cannot be too tight, as it would cause pressure spots. They should not be too loose either, as excess movement of the foot inside the shoe can cause friction and abrasions.
• The front of the shoe should be at least 1cm from the longest toe.
• The width should correspond to the splay of the forefoot.

Natural materials

• Natural materials such as leathers are more breathable and are softer on the foot. Mesh is also a good option as it is less restrictive.
• Softer materials can allow stretch to accommodate foot prominences such as bunions.

Seamless uppers

• Ensure that the shoe upper and interior is seamless to prevent pressure spots.

Adjustable uppers

• Laces and Velcro closures provide a better fit and give more support than a slip on shoe such as a loafer.

Removable insoles

• This allows custom orthotics to be placed in, and also allows more volume in the shoe.

Strong forefoot rocker and sole

• A strong sole can help protect the foot from impact forces from the ground.
• A forefoot rocker can assist with pressure distribution during gait.

Strong structure

• Good structured shoes such as a strong heel counter can help with lower limb stability.
• Custom orthotics should also be considered to improve pressure distribution and to prevent malalignment of the lower limbs.
• Footwear modifications can also be done if specific features are needed, or if a shoe needs to be adjusted for an individual’s needs.
• Custom orthopaedic shoes may have to be made in more severe cases such as a Charcot foot deformity

Other Things of Note

1. Clean your feet daily, and ensure it is dried properly.
2. Wear diabetic seamless socks, and/or compression socks (discuss this with your doctor).
3. Do not walk barefeet, this increases risk of abrasions. Wear supportive footwear even at home
4. Check the inside of your shoes before you put them on to ensure there are no rocks or cracks
5. Check your feet everyday for abrasions, cuts or swelling.
6. Keep your nails well-trimmed and cared for. A foot care nurse can help.

By knowing more about the condition, you can help to prevent the progression of the disease and be in control of managing it. Footwear and feet care is just part of the treatment necessary to battle Diabetes progression. Ensure that you understand your condition via discussions with your doctor, or by attending education seminars.

 
For more information or advice on proper diabetic footwear features, feel free to drop by one of our Kintec locations.

Mei Poon, C.Ped (C)
Kintec Pedorthist