December 06, 2016
For most people a bad shoe day may mean a blister on the little toe or painful spot on bottom of the foot that goes away within a couple of days. But for people with diabetes, wearing shoes that don't fit can cause serious problems. In fact, poorly fitting shoes are the most common cause of foot injury in diabetics, which can be the beginning of major foot complications such as ulcers, infections and amputations.
The feet of all diabetics are at high risk for complications, but complications do not have to happen. Good blood sugar control reduces the risk of complications, but uncontrolled diabetes leads to persistent hyperglycemia, which results in complications. Nerve damage, or neuropathy, lessens the foot's ability to feel pain, temperature, or foreign objects they may step on, or may be in their shoes.
High blood sugar can also lead to narrowing of small and large blood vessels and poor circulation to feet. When blood flow is reduced in the feet, wounds heal more slowly or don't heal at all. The feet of diabetics all develop deformities and change shape. For all these reasons, it is vital for diabetics to wear well-structured and properly fitting shoes to prevent complications. There are many studies that have proven that if diabetics wear therapeutic/diabetic shoes, they can help prevent ulcers and amputations. Here are some simple guidelines on the types of shoes diabetics should wear to protect their feet.
A diabetic-style shoe is made of soft leather and has a deep toe box (front of the shoe) that is square or rounded; a wider toe box can accommodate deformities like hammertoes and bunions. Shoes with laces or Velcro are a better choice because they fit the foot better, offer more support and can be adjusted if the foot swells. When buying shoes, here are some tips to remember:
o Buy shoes made of soft, stretchable leather.
o Shop for shoes later in the day because feet swell as the day progresses.
o Leave a thumbs-width distance between the end of the toe and the shoes.
o Ensure a proper fit by always trying on shoes while wearing the socks that you'll be using.
o Don't wear new shoes for a full day at the beginning. Wear new shoes for one to two hours first -- check the feet for cuts, blisters or irritation. Gradually increase the time until you get to the entire day to make sure they aren't injuring your feet.
o Replace old shoes when the heel begins to collapse to one side, the bottom of the heel is worn down or the inner lining of the shoe is torn.
The type of shoes diabetics wear is dependent on a number of factors, including if they have neuropathy or deformities, the shape and size of their feet.
Diabetes patients who have good blood sugar control and healthy feet with good sensation and no deformity may wear well-structured, traditional shoes that have good arch support and a rounded or square mouth. An Oxford or Mary Jane-type shoe, or athletics sneakers for walking or jogging are good examples. However, because of their risk, all diabetics must be vigilant and check their feet carefully each day for blisters, sores, cuts, redness, warm areas, swelling, ingrown toenails, etc., regardless of the type of shoes they are wearing.
Diabetic women with good foot health, circulation, sensations and no foot deformities may wear fashionable high heel shoes for short periods. Women with loss of sensation or deformities should avoid high heels and narrow dress shoes because they cannot feel the pain and stress such shoes would place on their forefoot and toes.
If the diabetic has poor glucose control, poor circulation, loss of sensation, a deformity or a previous ulcer or amputation he or she will need special diabetic shoes, protective footwear and inserts; such a "shoe prescription" is written by a podiatrist. Extra depth (deeper) shoes combined with custom-molded inserts effectively redistribute pressures on the foot as the diabetic walks. Patients with very bad foot deformities that cannot be accommodated in regular shoes may need custom-molded shoes, which means that the entire shoe is made from a cast of the patient's foot.
Diabetics should avoid wearing flip-flops as a general rule. These shoes are generally very thin and flimsy and do not offer any protection from punctures, support or structure to the feet. They leave the toes exposed and at risk for injury. Further, because they go between the toes they can cause rubbing that may lead to blisters or ulcers that the diabetic may not feel if they have loss of sensation to the feet.
It is common for diabetics to not be wearing their prescribed diabetic shoes at the time of an injury. All diabetics who are prescribed any type of therapeutic/diabetic shoes or inserts must wear them regularly. That means wear them every day, all the time. This is the only way to protect the feet and get the benefit of the shoe.
People with diabetes must choose their shoes carefully, and often times it will require some sacrifice. People complain that diabetic shoes are not stylish enough, but there are more attractive shoes being produced every year. And diabetics must remember that these shoes play a vital role in protecting the feet and preventing injury from more stylish, improper shoes. They also complain that the shoes are costly. They should remember that these shoes are good quality, well-made shoes that last a long time. It is definitely worth the sacrifice to protect your feet from injury, ulcers and amputations so they can last a lifetime.
o For more information email email@example.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport Grand Bahama, telephone 373-7400.
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