101 Tips on Foot Care for People with Diabetes
by Jessie H. Ahroni, PhD, ARNP, CDE, BC-ADM and Neil M. Scheffler, DPM. FACFAS, FAPWCA.
Copyright © 2006 by The American Diabetes Association.
Excerpted with permission of the publisher, The American Diabetes Association.
For more information or to order this book, please call the American Diabetes Association at 1-800-232-6733, or visit http://www.shopdiabetes.org/.
NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.
Chapter 4 – Shoes and Socks Tips
35 – What are the best shoes to wear when you have diabetes?
A lace-up show with a high, rounded toe box is ideal. The upper part of the shoe should be a soft, breathable material such as leather or fabric instead of plastic or synthetic materials. Avoid sandals, clogs, thongs, or flip-flops, because they do not provide the same protections that as closed shoe does. If you have a callus or deformity, you need a shoe with a soft innersole that redistributes the pressure on the sole of your foot. With a bunion or hammertoe, you may need extra-width or extra-depth shoes.
If you have trouble tying laces, try shoe with Velcro fasteners. Most tied shoes can be converted to Velcro fasteners at a shoe repair shop. Elastic shoelaces allow you to get your shoes off and on without untying the laces.
Avoid tight, pointed shoes. High heels are not good for any foot – especially ones with diabetes. They force the entire weight of the body onto the front of the foot, changing the shape, greatly increasing pressure, and causing ulcers. Look for a shoe that is shaped like a foot. While this sounds reasonable, it can be a challenging task, especially for women. A pedorthist (certified show fitter) can help you pick the right shoe. It's worth the effort. Good-quality athletic shoes or walking shoes are often excellent choices as well.
36 – I've been told that people with diabetes should wear shoes all the time. I have wall-to-wall carpeting, and I like to go barefoot in my home. Should I?
No. Carpeting does not prevent you from stepping on pins, tacks, toys, dog bones, and whatever the cat brought in. Doctors often remove small pieces of glass, wood splinters, and even needles from dropped insulin syringes from the feet of people who have walked without shoes at home. Over 80% of amputations can be traced back to a minor traumatic event!
Most people do not take their shoes off before they enter their homes. The shoes track in viruses, fungi, and bacteria, which are deposited on floor surfaces. Viruses can cause warts, fungi can cause athlete's foot and nail diseases, and bacteria can cause infections. If you walk barefoot in your home, you may come in contact with these disease-producing organisms.
Make it a habit to protect your feet at all times – at the beach or pool (water shoes), in public showers (shower shoes), and even in your own home (house slippers or shoes). The only time to go without shoes is when you are in bed or bathing.
37 – How can I tell whether my shoes fit?
One way is to purchase then from a podiatrist (foot specialist) or a trained shoe fitter (pedorthist). Have both feet measured every time you buy shoes, and shop for shoes in the afternoon or evening when your feet may be swollen. Your shoes need to fit all day. When you try on shoes, check that the ball of the foot rests in the widest part of the shoe. Notice whether the shoe bends where your foot does, and be sure there is plenty of room for your toes. There should be a half-inch space between the longest toe and the end of the toe box, but the shoes should not slip. (The longest toe is not always the big toe.) be sure the toe box is high enough and does not press on your toes.
If you have foot deformities or have had an ulcer that is now healed, you should have shoes prescribed or fitted or custom-made by a podiatrist, orthopedic surgeon, or pedorthist. If you have nerve damage, even your properly fitted new shoes may feel too big. Also remember that people's feet tend to get longer, wider, and flatter as the years go by. You will not always wear the same size.
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Last week, Lindsey railed about that portion of the diabetes community that seems to seek pity for complications that seem to arise from the deliberate neglect of that insulin-sucking monkey on our shoulders. While I agree that deliberate self-mistreatment for its own (or pity's) sake is more indicative of mental illness than anything else, I'm more likely to ask about the reasons why a person might...