Diabetes and foot problems
High blood sugar contributes to poor blood circulation. It can also damage nerves in your feet, a condition called neuropathy. Neuropathy can cause you to lose feeling in your feet, which may make it difficult for you to realize if you cut yourself or injure your foot. If you leave a cut untreated, it can lead to an infection. Poor circulation can make it difficult to heal cuts and infections.
You might develop open sores on your toes or the bottom of your feet. You may also develop calluses, or thick areas of hardened skin. The following are all more likely to occur in people with diabetes:
- bunions
- corns
- fungal infections
- gangrene
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Nerve damage can also change the shape of your feet. People with diabetes are more likely to develop hammertoe, which is a deformity that causes the toe joints to bend inward.
Even foot problems that might seem insignificant, like blisters or athlete’s foot, can be a cause of concern if you have diabetes. Because of poor circulation to the area, any foot problem will take longer to heal and may instead compound and grow into a dangerous infection that can progress and lead to amputations if not correctly treated. That’s why any foot issues should be called to the attention of your doctor if you have diabetes.
Foot injuries and changes to the foot’s shape can make your regular shoes feel uncomfortable. Wearing shoes that are too tight or too loose can put you at risk for foot problems, or make your foot problems even worse. Don’t try to squeeze your feet into uncomfortable shoes. Instead, ask your doctor or podiatrist about special shoes made for people with diabetes. By wearing the right shoes, you’ll be more comfortable and you’ll keep your feet healthier.
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DIABETIC SHOES
What kind of diabetic shoes do I need?
If your diabetes is under control and you don’t have any real foot problems, a comfortable, well-fitting shoe may be all you need. But if you do develop any foot problems, your doctor might recommend one of these shoe options:
In-depth shoes
In-depth shoes are 1/4 to 1/2 inch deeper than normal shoes. The extra room can accommodate foot changes like calluses or hammertoes. In-depth shoes also leave enough room for inserts if you need them.
Healing shoes
Healing shoes are worn while you recover from foot sores or foot surgery. They come in open sandals or closed-toe versions. Generally, open-toed shoes aren’t recommended for people with diabetes unless ordered by your doctor.
Custom-made shoes
Custom-made shoes are created from a mold of your foot. This type of shoe may be an option if your feet have a deformity.
In general, therapeutic shoes are specifically designed to keep your feet healthy if you have neuropathy, nerve damage, or an existing foot injury.
Orthopedic shoes are shoes designed to give more comfort to those with bunions, corns, or other foot problems. Not everyone who wears orthopedic shoes has diabetes. A great variety of orthopedic shoes are available, no matter what style of shoe or type of sole you prefer.
In addition to buying new shoes, you can also modify shoes you already own. For example, you might add a thicker, more shock-absorbent sole. You could also add orthotics. These are footpads or inserts placed inside your shoes to take pressure off of your feet and provide added comfort.
WHERE TO FIND
Where to find diabetic-friendly shoes
Start with a visit to your primary care doctor, endocrinologist, or podiatrist, who can check your feet and recommend the right shoe. You might also see a specialist to get fitted. An orthotist is a medical practitioner that can design, prescribe, and make diabetes footwear. A pedorthist is trained to fit and modify shoes.
A specialist might order your shoes for you, or you may get them through a pharmacy, online store, or specialty shoe store. Medicare will cover the cost for one pair of therapeutic shoes if your doctor prescribes them. Check with your insurance provider to learn more about your coverage.
Dr. Comfort, Hush Puppies, and Prophet are well-known brands that manufacture therapeutic and orthopedic shoes. Shoes with the American Medical Association’s Healthcare Common Procedure Coding System (HCPCS) code A5500 or A5501 are classified as diabetic footwear and may be covered by Medicare or your health insurance provider. The sneaker brand New Balance also makes shoes with these codes.
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FEATURES
Features to look for in diabetic shoes and socks
Finding a good shoe is important if you have diabetes. Below are some tips that may help.
It’s also important to find a shoe that fits well and matches the shape of your foot. You don’t want your foot sliding around inside the shoe. This can cause blisters, sores, and calluses, which can be dangerous for a person with diabetes.
Additionally, choose a shoe that can accommodate changes in your feet, such as hammertoes.
To find just the right fit for your feet, see a specialist for a fitting whenever you buy new shoes. Be sure to wear the same socks you’ll normally wear with these shoes to ensure proper fit.
Shoes to avoid
If you have diabetes, you should avoid wearing certain types of shoes:
- Avoid any shoe with a pointed toe because it will aggravate your toes and restrict circulation.
- Don’t wear shoes without arch support, as they may lead to the breakdown of tissue in your foot.
- Be careful to avoid shoes that don’t fit properly, as those could injure your feet.
- Wear high heels sparingly it all. If you do wear high heels, round-toe styles with heels below 2 inches are best.
Diabetic socks
Diabetic socks are socks that don’t constrict the foot and are designed to promote healthy circulation. Most brands don’t contain elastic, and some brands are moisture-wicking. Diabetic socks that keep the foot dry can help prevent infection. The following are brands of different diabetic socks:
- Truform
- Dr. Comfort
- Activa
- Drymax
For the most part, diabetic socks can be made to look like regular socks and come in many different lengths, colors, and styles.
If you don’t want to purchase socks specifically made for people with diabetes, look for regular socks made with moisture-wicking fabric. Be careful of rough seams along your sock’s toe area, which could lead to blistering, and buy socks that come above the ankle for this same reason. Avoid compression socks, which will have a negative effect on the circulation in your feet.
FINDING THE RIGHT FIT
Finding the right fit
If you’re able to purchase two pairs of therapeutic shoes, it’s a good idea to alternate between them. This will preserve the shock absorption and prolong the lifespan of both pairs of shoes. Once the heels of the shoe begin to wear down, or if one side of a shoe starts to collapse, stop wearing that pair and transition to a new pair. Wearing worn-out therapeutic shoes defeats the purpose of having them.
In general, most insurance companies will replace a pair of diabetic shoes every two years. Diabetic shoes that are worn daily will generally need replacing by that time.
Getting new shoes is just one way for people with diabetes to care for their feet. You should also see your podiatrist for annual checkups and take good care of your feet every day to help keep them in top shape.
Even if you’re wearing diabetic shoes, follow these tips to make sure your feet are healthy:
- Check your feet every day to make sure there are no developing sores, ulcers, or calluses.
- Trim your toenails regularly, making sure to cut straight across to prevent ingrown toenails.
- Smooth your corns and calluses gently with a pumice stone or an exfoliating foot scrub.
- Avoid using razors or other sharp tools on your feet.
- Wash your feet daily with warm water to promote circulation.
