Find the Right Shoes for Diabetes
Experts discuss the best shoe options to avoid foot problems linked to diabetes.
Shoes for Diabetes: Choose Shoes Wisely continued...
Which shoes are not good for anyone with diabetes? Flip-flops, Giurini says. "They expose the toes [to injury], they're not very supportive, and the strap that goes between the toes can cause a blister or irritation."
"I'm not a really big fan of rigid leather-style shoes," he adds. "They don't give, so that if there's a blister or irritation, there's no opportunity for the shoe to expand."
As for Guanci, he takes foot safety a step further by wearing protective water shoes during swimming. Going barefoot exposes feet to injury, so wearing slippers in the house is also a good idea.
If diabetes patients do develop minor foot deformities or impaired sensation and circulation, it's smart to move from conventional footwear to buying comfort shoes or diabetic shoes, according to Giurini.
These shoes are marketed under various brands, such as CrocsRx, P.W. Minor, Drew, or Easy Spirit.
"A diabetic-style shoe is characterized by being made of soft leather, has a deep toe box, has a rounder, wider toe box that can accommodate things like hammertoes and bunions," Giurini says.
Experts also mentioned jogging shoes or walking shoes as good alternatives.
Patients have complained to McGuire that diabetes forces them to wear unfashionable shoes. "They have to change what they wear, how they look a little bit," he says. Some resist. "It's that basic desire just to remain normal, to not admit that they have diabetes or that they have to make some lifestyle changes." But the harm from improper footwear is too serious to chance, he says.
"They don't need to wear granny shoes," Snow adds. "But folks really have to make sure that what they're putting their foot into is not going to give them a problem."
'Shoe Prescription' for Diabetes Patients
If foot circulation or sensation worsens or a patient develops ulcerations, significant deformities, or other serious issues, a podiatrist may need to prescribe therapeutic shoes, or protective footwear and inserts. Medicare covers these treatments.
For example, some patients require "depth shoes" combined with custom-molded inserts to redistribute pressures on the foot. "Most ulcerations that occur on the foot are pressure-related," Giurini says.
"Depth shoes" derive their name from the extra depth to accommodate orthotics.
Patients with extreme foot deformities may need custom-molded shoes, in which the entire shoe is molded from a cast of the patient's foot. "These are for individuals with very severe foot deformities that can't possibly be accommodated in any other shoe gear," Giurini says.
Diabetes patients who are prescribed any types of medical shoes must wear them religiously, McGuire says. He tells of one man undergoing treatment for a hard-to-treat heel ulcer who cast aside his protective boot to walk around the mall in regular shoes. It was Christmastime and "he wanted to have a nice, normal day with his wife," McGuire says. The patient ended up with bone breakdown, a chronic wound, and bone infection that eventually led to amputation of his foot.
"This didn't have to happen if he had continued to follow directions," McGuire says. Diabetes patients "just can't take that risk once they have that loss of sensation."