Find the Right Shoes for Diabetes
Experts discuss the best shoe options to avoid foot problems linked to diabetes.
Shoes for Diabetes: Double Trouble for the Feet continued...
Besides loss of sensation, diabetes can also cause poor circulation because high blood sugar can lead to narrowing of small and large blood vessels. When blood flow is reduced in the feet, wounds heal more slowly.
Besides these two major threats, foot deformities, such as bunions or hammertoes, can also create pressure points that result in ulcerations, according to McGuire.
"Any kind of injury or damage to the foot is the main concern," says Kenneth Snow, MD, acting chief of the adult diabetes department at the Joslin Diabetes Center. "Certainly, ulcers are one such problem, but any kind of laceration injury can lead to significant problems if unrecognized and untreated, particularly in those at risk." At worst, foot complications can lead to amputation.
Most foot complications occur after a patient has had diabetes for 10-15 years, says John Giurini, DPM, chief of podiatry at Beth Israel Deaconess Medical Center. But, he adds, "For individuals who are under very poor control, the complications may occur sooner."
Shoes for Diabetes: Choose Shoes Wisely
When it comes to shoe selection, numerous factors crop up -- not just how long someone has had diabetes, Giurini says. "Do they have normal sensation in their feet? Do they have any abnormalities or deformities of their feet? That's really what should be taken into consideration when selecting shoe gear," he says.
Diabetes patients with good blood sugar control and healthy feet can wear conventional shoes, experts tell WebMD. "They're not at any greater risk for problems than the average population. They can kind of wear whatever they would usually wear, realizing that they should inspect their feet regularly," McGuire says. Experts urge all diabetes patients to check their feet carefully each day for blisters, sores, cuts, redness, warm areas, swelling, ingrown toenails, and other abnormalities and report such changes to their doctor.
For diabetic women with good foot health and no foot deformity or only minor ones, even high heels are fine. "They can certainly wear a fashionable-style shoe for short periods of time, maybe when they're not going to do a lot of walking," Giurini says. He suggests that they save high heels for the office and wear sneakers to and from work. If they slip into heels for a business presentation, they should consider wearing comfortable shoes before and after, he adds.
But women at higher risk for foot problems should eschew the high heels. "A diabetic patient who has some significant loss of sensation, poor circulation or has things like hammertoes and bunion, have to be much more careful," Giurini says.
McGuire advises patients with impaired sensation to steer clear of high heels and narrow dress shoes because they can't feel the pain and stress that such shoes place on the forefoot and toes.