If the Shoe Fits, Wear It

June 26, 2008
By Johns Hopkins Health Alerts, www.johnshopkinshealthalerts.com



If you have diabetes, it's particularly important to take good care of your feet and to always wear comfortable, well-fitting shoes. Here are some tips to keep in mind.

Foot health or fashion fetish -- you make the call. If you have diabetes, it would be wise to put your feet first and take a pass on attractive but ill-fitting shoes. What would otherwise be a small blister that heals in a few days could, in someone with diabetes, turn into an infected foot ulcer requiring hospital care or, in extreme cases, amputation.

Just about everybody could use a pair of shoes that fit well and don’t rub or chafe. But if you are at risk for slow-healing foot ulcers because of your diabetes, appropriate footwear is essential to your health.

Do special "diabetic" shoes or custom orthotics prevent foot problems in people with diabetes? The truth is that the research so far isn’t completely clear on this question. There is some evidence that people at increased risk of diabetic foot ulcers -- because of peripheral neuropathy (nerve disease), peripheral arterial disease (impaired blood circulation), or foot deformities -- may benefit from custom footwear.

What you don’t want your shoes to do is rub, squeeze, blister, or chafe your feet. Custom shoes should accommodate any foot deformities and defuse "hotspots" of pressure on the bottom of the feet so that walking does not injure the skin. You may need custom-made inserts for your shoes or a fully customized shoe. Talk to your podiatrist. He or she can refer you to a therapeutic shoe-fitting specialist, or pedorthist. Some podiatrists do the fitting themselves.

If you are not at special risk of foot ulcers, a good-quality, well-fitting shoe is probably all you need. For example, if you plan to walk frequently for exercise, buy a name-brand athletic or walking shoe. When shopping, try on shoes late in the afternoon, when your feet tend to be larger because of fluid retention.

Shop in person; buying shoes online means you can’t try them on. When shopping for dressier shoes, the front of the shoe (toe box) should be wide and deep enough to allow you to wiggle your toes. Look for shoes made of a breathable material, such as soft leather, instead of synthetics. Break your new shoes in slowly by wearing them for a short period every day. Don’t buy shoes that you like the look of but that don't fit, thinking you will "wear them in."



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