Walking Shoes for Diabetics

Source: AARP.org |  | June 8, 2007

If you're a person who walks and who also has diabetes, wearing the right shoes is especially important. Diabetes increases your risk for developing foot problems, if you do not already have them, which can lead to health complications. If you have diabetes, you may experience blisters, calluses and ulcers. Proper shoes can help prevent these problems. A doctor or footwear professional can help you choose the right shoes. Even if your feet don't hurt now, the right shoes can prevent problems from developing in the future.

Choosing Shoes That are Right for You

If you have diabetes, you want to buy shoes that:

• Relieve pressure on your feet. Too much pressure on the foot can lead to skin breakdown or ulcers. Shoes that fit too tightly or have rigid stitching can cause pressure. So can any bones that stick out on the feet.
• Properly fit the shape of your feet. Some conditions can change the shape of your feet, such as loss of fatty tissue, hammer toes, or loss of a toe. Wearing shoes that fit and support your feet, if you have any of these conditions, can help relieve pain and avoid further damage.
• Reduce shock and shear. You want shoes that will reduce the downward pressure (shock) on the bottom of your feet, as well as the sideways movement of your feet within the shoes (shear).
• Limit motion of joints. Limiting the motion of certain joints in the feet can often reduce swelling, relieve pain, and make your feet more stable and functional.

Other Things to Consider

Size differences. Don't choose shoes by the size marked inside. Go by how they feel on your feet. Even though you measure your feet, sizes can vary by style, shoe brand, company and the country that makes the shoes. Make sure your shoes have enough room in the toe area, over the instep, and across the balls of your feet. The shoes should also fit snugly around your heels.

Width and length. Width is just as important as length when it comes to shoe size. The proper shoe size is the one where the widest part of the foot, the base of the toes, is in the widest part of the shoe. There should also be a 3/8-inch to 1/2-inch space between the end of the shoe and the longest toe.

Lacing up. Shoes with laces let you adjust your fit if swelling or other conditions that change the shape of your feet occur. Laces can also keep your shoes from slipping off.

If you are in the early stages of diabetes and have no history of foot problems or any loss of feeling in your feet, a properly fitting shoe made of soft materials with a shock-absorbing sole may be all you need.

Pedorthists. If you have numbness in your feet (neuropathy), a history of foot ulcers, or any changes in your foot structure, you should be fitted by a board-certified pedorthist. A pedorthist is someone who is trained in the assessment, design, manufacture, fit and modification of foot appliances and footwear. People who lose feeling in their feet tend to buy shoes that are too tight. The size that "feels" right is often too small and the shoes may end up causing problems.

Special Shoes

Many people with diabetes need special footwear prescribed by a doctor. Some of the prescription footwear includes:

Healing shoes. Sometimes people need to wear special shoes right after surgery or ulcer treatment. These include custom sandals (open- toe), heat-moldable healing shoes (closed-toe), and post-operative shoes.

In-depth shoes. The in-depth shoe is the basis for most footwear prescriptions. It is generally an oxford-type or athletic shoe with an extra 1/4-inch to 1/2-inch of depth throughout the shoe, allowing extra room for any needed inserts or orthotics, as well as foot changes commonly associated with a diabetic foot. An orthosis is a removable insole that relieves pressure and absorbs shock. In-depth shoes also tend to be lightweight, have shock-absorbing soles, and come in a wide range of shapes and sizes to fit nearly any foot.

External shoe modifications. These shoes are modified on the outside by changing the shape of the sole or adding shock-absorbing or stabilizing materials.

Orthotics or inserts. Both pre-made and custom-made orthotics or inserts are commonly prescribed for people with diabetes, including a special "total contact orthosis," which is made from a model of your foot and offers a high level of comfort and pressure relief.

Custom-made shoes. For extremely hard-to-fit feet, a custom-made shoe can be constructed from a cast or model of a person's foot. These cases are rare. Major modifications of in-depth shoes can usually do the job of fitting even the most unusual foot shape.

Taking good care of your feet means making sure you have the right shoes. Whether you have been recently diagnosed or have had diabetes for many years, the proper shoes can help you walk in comfort and prevent serious foot problems. Be sure to talk to your doctor about the type of shoes, modifications, and inserts that are right for you.