How to Choose the Right Shoes When You Have Diabetes

Tips for Assessing Your Footwear

Picking the right shoes size when you have diabetes can be challenging

Whether someone has been recently diagnosed with diabetes or has been managing for years, preventive health is crucial to reduce the long-term complications of diabetes.

Neuropathy, or nerve damage, is one type of long-term complication that can also affect the feet. This occurs because the nerve damage affects the ability to sense pain on the feet that may be caused by a cut or sore.

If not treated, it may lead to ulcers and further damage. Also, corns and bunions can also increase the risk of getting sores on the feet since shoes do not fit correctly.  Circulation problems may also affect the feet and may require special shoes to aid in healthy circulation.

The best way to proactively address your diabetes-related foot problems is to make sure that your shoes are comfortable, well-fitting, and protective. Since appropriate shoes can prevent new injuries and stop existing problems from getting worse, proper footwear is important at all stages of diabetes.

What to Consider When Choosing Shoes 

  • They should relieve pressure on the feet. Shoes should be comfortable and cushioned to help take pressure off the bottoms of your feet and reduce the risk of getting blisters and ulcers. A good shoe for everyone should have shock-absorbing soles that take the pressure off the bottom of the feet. To make an existing pair of shoes more comfortable, wear padded socks, add in a lift, or buy cushioned insoles. Also, look for shoes that have laces you can loosen or tighten. This is essential in order to accommodate any swelling or foot changes that occur over time.  A podiatrist (foot doctor) can help determine what you need.
  • They should protect the entire foot. People with diabetes should avoid going barefoot or wearing flips or flimsy sandals, since this leaves your feet open to injuries and infections. Leave a pair of comfortable shoes by your bed so that you can easily slip into them in the middle of the night. Try to find a lightweight shoe that will help your feet move easily. Choose a flexible material, like canvas, leather or suede. Be sure the shoe has a solid back in order to provide extra support but should fit snugly around the heel.

  • They should be the appropriate size. Have your feet regularly measured, even if you think they have not changed. Shoes that are too small can cause rubbing and lead to painful blisters and sores. Since our feet tend to swell a little bit by the afternoon, it is best to be measured and buy shoes later in the day. That way, it accommodates the natural swelling and reduces the pressure of a shoe that is too-tight. Always try on shoes with the same socks that you plan to wear with them. Wearing thinner socks could cause you to buy shoes that are not the right size. Pay special attention to how the shoes make your instep and ball of the foot feel— there should be plenty of room for them to move. It is also important to allow at least a ½ inch of room between your toes and the top of the shoe.
  • They should be suitable to wear for hours at a time. Take new shoes out for a test run; wear them for a few hours and carefully assess the way your feet look and feel. If you are heading out for the entire day, take a comfortable backup pair so that you can switch your shoes after a few hours, allowing your feet to breathe.

Types of Shoes to Avoid

  • Shoes with pointed toes. While they may look cute, they tend to restrict the toes and reduce circulation. 
  • Shoes WITHOUT arch support. Without arch support, this can increase risk of tissue breakdown on the foot.
  • Old shoes you already have that do not fit properly. Donate them to your charity of choice to give them a new home, but it is wise not to wear them or they could cause injury.
  • Heels especially anything more than 2 inches. Even without diabetes, wearing heels provide minimal support so it is recommended to only wear for special occasions, if at all.
  • Shoes that are not comfortable. In the past, we would always accept that new shoes need time to be “broken in”. Honestly, the best shoes are those that feel great right out of the box. So, if you are not “feeling it”, put them back.

While there are many types of shoes available in stores, ask a sales associate about shoes that are both therapeutic and stylish.Your doctor may recommend certain types to accommodate your needs. For example, if someone has hammertoes, calluses or other foot changes, in-depth shoes may be helpful. These types of shoes are up to ½ inch deeper than normal shoes and that extra room can accommodate foot changes like calluses and hammertoes and also allow for inserts or orthotics.

Healing or post-op shoes are typically used when someone needs to stay away from regular shoes to allow foot sores to heal or after foot surgery.Although it's possible to find therapeutic shoes in the open-toe style, it's best to avoid these options. 

Consider custom shoes if you have a foot deformity or other special foot concerns. Custom made shoes are specially designed using a mold of your foot. They are specially designed to keep the foot healthy when someone has neuropathy or more complex foot issues, like Charcot foot. A podiatrist can help determine what is right for you.

Talk to your podiatrist about your shoe needs, and make sure to check with your insurance carrier to see if therapeutic footwear is covered. Additionally, some patients may be eligible for coverage under Medicare’s Therapeutic Shoe Bill which helps people with diabetes cover the cost of some therapeutic shoes and shoe inserts.

Having the right shoes are essential, but it is important to make the following foot care regimen an ongoing part of your days:

  • Check your feet for cuts and sores, especially the bottoms and in between the toes. Use a mirror if you cannot easily see the bottoms of your feet.
  • Cut your toenails straight across (do not cut the corners)—use a nail file to round the corners, if necessary.
  • If your doctor allows, use a pumice stone to gently smooth corns and calluses.
Updated on: August 15, 2019
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