Diabetes affects over 11.3% of Americans which equates to roughly 26 million people annually. Two of the major physical complications of the disease include neuropathy – or loss of sensation, and circulation issues – IE: cold extremities. One of the first things medical professionals suggest when diagnosing the disease is that the patient invests in a proper pair of diabetic shoes. And yet very few patients follow through with that suggestion until it’s too late. Why is this the case?
Mainly because troublesome leg and foot issues often don’t appear for several years. And by the time they do, the patient may have no clue of the issue because he has lost the sensation in his feet and has not seen the damage. Improper foot care can lead to sores and blisters for anyone, but it goes beyond simple sores with diabetes. Bruises, skin abrasions, ulcers. But doctors also see patients who have stepped on knitting needles or syringes, nails, or broken glass and haven’t felt the pain.
Diabetes leads to the narrowing of blood vessels, which causes blood to slow. This causes wounds to heal at a highly reduced rate. In some cases, that can lead to amputation. Such problems are avoidable by wearing proper diabetic shoes. But what are the most important characteristics of diabetic shoes?
Material Matters
A good diabetic shoe will be flexible enough to fit as the day progresses. Even healthy feet tend to swell towards the evening hours. But edema is known to accompany diabetes even if the patient hasn’t been on their feet much of the day. Soft leather and mesh are the best stretchable fabric options for diabetic shoes.
Toe Box
The toe box is the area of the shoe that stretches over the toes. While narrow or pointed shoes are fashionable, they cut off the circulation and cause more issues for diabetics. The right diabetic shoes must have a long enough toe box to give a thumb’s width of space between the longest toe and the edge of the shoe. It must also be wide enough to allow wiggle room and no rubbing of any toe against the shoe’s edge.
Shoe Width
Good diabetic shoes come in a variety of shoe widths. Each person is different, just as each diabetic reaction is as well. Focus on fit. And if the shoes you want don’t come in the right width, choose one that does. Function is more important than form when it comes to diabetic foot care.
Seamless Lining
Most decent shoes have linings nowadays. But with sensitive feet, extra stitching can cause skin abrasions and sores. And it can happen every time you slide your feet into your shoes – even while wearing socks. Diabetic shoes should come with an interior soft fabric or nylon lining that is completely seam-free.
Double Removable Insoles
Extra interior footbed padding is essential to diabetic care. The right shoes will contain at least double the thickness of a regular footbed, and it will be removable. This is so that IF you require prescription orthotics during your treatment, you can add and remove those at will. This will also extend the life of your specialized health shoes.
Rocker Platform
Shoes with thick, shock absorbing soles that angle upward from the heel to the toe are called rocker bottom or rocker platform soles. This component emulates the natural rocking motion of the foot during walking. That’s especially beneficial for those who have mobility issues due to joint pain or extreme neuropathy. The rocker also propels, which reduces stress on sensitive foot skin.
Have the Right Medical Requirements
Many shoes have one or more of the above listed characteristics of diabetic shoes. But those labeled as being meeting the minimum HCPCS A5500 requirements are Medicare approved in most cases. This means they’re medically intended to support diabetic needs and in most cases are covered or reimbursed by Medicare. This can be a serious bonus for those on a fixed income or budget. And who isn’t nowadays?
Is Diabetic Footwear Absolutely Necessary?
If you have diabetes, it is important that you wear properly fitting footwear because one common side effect of diabetes is a condition known as peripheral neuropathy. This condition can cause loss of sensation in your feet and hands. If your shoes do not fit properly, they can cause severe damage to your feet without your being aware of it. A blister or abrasion can become infected and may take a very long time to heal, or it may not heal at all.
Getting diabetic shoes that are properly fitted to your feet goes a long way toward preventing these potentially life and limb threatening injuries. This type of specially designed footwear is called “pedorthics”. It consists of both shoes and insoles that are made to prevent and/or relieve pain and injury to sensation-compromised feet.
How Are Diabetic Shoes Different From Ordinary Shoes?
Shoes designed for diabetics are typically deeper and wider than ordinary shoes. This special design ensures plenty of room for diabetic insoles which may be custom made to fit your feet perfectly. These specialized insoles help redistribute your weight to prevent pressure points, blisters, abrasions and ulcerations.
Diabetes can cause nerve damage in the feet (peripheral neuropathy) which causes your toes to go numb. When this happens, you will not know it if your shoes are causing a blister. The extra room provided by diabetic shoes helps protect you against this situation.
The toe box of shoes designed for people with diabetes is extra high and wide. This helps prevent having your toes rub against the inside of the shoe or against one another. The roomy design of diabetic shoes also helps prevent pinching and rubbing on the tops and sides of the feet. This sort of frictions can cause blisters and hot spots and may result in ulceration.
Diabetic shoes also have especially wide, thick soles to help protect and cushion your feet against bruises, wear and tear and injury. The uppers of these shoes are usually made of soft, breathable fabric to help prevent problems with athletes’ foot which can cause severe irritation. For people with diabetes, these kinds of minor injuries and irritations can result in such severe consequences as amputation.
Consult With A Professional
You might think that just going with flip flops or sandals would be a good way to avoid having your shoes injure your feet, but unfortunately this isn’t true. When you have peripheral neuropathy, you must avoid going barefoot or having your feet exposed to potential injury. It is important to wear shoes that support your heels, arches and ankles and protect your feet against potential nicks, cuts and bruises.
Your shoes must provide good support to encourage correct ambulation. If your feet tend to roll inward or outward or you have some other gait abnormality, poorly fitted shoes are bound to cause blistering and sores. Shoes that are designed to correct your gait and support your feet and ankles prevent this problem.
If you have compromised sensation in your feet, it is important to go to a trained professional to have your diabetic footwear properly fitted because you may not be able to feel whether or not your shoes fit correctly. A professional will be able to measure carefully and evaluate whether or not the shoes you are wearing will provide the right amount of support and protection while allowing good air circulation and promoting healthy blood circulation.
How To Shop For Diabetic Shoes
When you go to a trained professional, you should have nothing but good choices presented. Nonetheless, five precautions you should take when making your selection.
- Be on the lookout for seams inside the shoe. A seam may not feel bothersome at all, but it can create a pressure point that leads to injury. The lining of your shoes should be smooth, soft and seam free. Check it with your fingers as well as your feet. Have a friend check for you if you have limited sensation in your fingers.
- Choose shoes that fasten with Velcro or laces over slip-on styles. A slip-on shoe that fits correctly in the morning may be too tight by afternoon. When this happens, you may not be aware of it if you have reduced feeling in your feet. Shoes that lace or strap on can be adjusted periodically throughout the day to accommodate any swelling.
TIP: Be sure to try on new shoes in the afternoon as everyone’s feet tend to swell as the day progresses. Choosing shoes in the afternoon ensures that you will get a comfortable fit. - Check to be sure that the insole of any shoes you are considering can be removed and replaced. The insoles of your shoes may tend to wear out more quickly than the rest of the shoe. Being able to replace them with over the counter or prescribed insoles saves you money and ensures that your feet are always properly supported.
- Don’t buy diabetic shoes online. Even though it may seem convenient, it is especially important that you get a good fit when you are purchasing diabetic shoes. Go to an actual shoe store specializing in this type of footwear. Your doctor can give you a recommendation. Check to see if your insurance will cover part or all of your purchase.
Is It Possible To Have Good Looking Diabetic Shoes?
You may be able to wear ordinary trainers or walking shoes. Check with your doctor and/or the specialist at your diabetic shoe store. They may be able to guide you toward shoe manufacturers who carry lines geared toward people with diabetes and other foot challenges.
Generally speaking, shoes designed to accommodate people with diabetes are not really haute couture, but if you have had painful feet or have experienced struggling to heal minor foot injuries you may very well come to believe that looks are not especially important. Properly fitting diabetes shoes can help you participate in life safely and with confidence.
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