| Choosing
shoes: a guide for people with diabetes
Older
adults have a lot to think about when it comes to being active—including
their feet. Deciding which shoes to buy is important for men and women who have
diabetes. What advice do the experts offer?
1. Fit
Timothy
Kalla, a clinical instructor with the University of British Columbia, says a professional
fit is the most important shoe feature for people with diabetes. There are four
main risk factors for foot problems for these individuals:
• Previous
problems;
• Loss of circulation;
• Loss of feeling; and
• Foot deformity (hammer toes, bunions, calluses, limitation of motion, etc.).
People are more likely to have foot problems when they have more risk factors.
So the person who fits the shoe must understand the effect diabetes has on the
feet.
2. Material
Footwear expert Phil Moore says shoes must
be smooth on the inside. It’s also better to have shoes with seamless toe
boxes, often with uppers made of heat moldable material or deerskin (as with orthopedic
shoes). Running shoes have more seams than is ideal, but the mesh often stretches
to make room for problem areas.
3. Size
Kalla says loss of
feeling is the greatest risk factor for foot trouble in people with diabetes.
He says that people with feeling loss typically buy shoes that are too small,
because they can feel the shoe. These people will complain that their shoes are
too big when fitted with the right size. But wearing shoes that are wide and long
enough can help prevent toenail injuries and reduce pain in the front of the feet,
says Moore.
4. Accommodation
Deformed areas are prone to rubbing,
says Kalla. For instance, a hammer toe may rub on the seam of a shoe. A pair of
extra depth (or “high volume”) shoes without seams and with a soft upper
is vital for someone with loss of feeling and foot deformity.
5. Protection
The skin around the foot thins with age, says Moore, so active older adults need
shoes with more padding. They also need socks that remove moisture from the feet
to cut down on blisters. Walking shoes usually don’t have the support, fit
or cushioning of a running shoe. According to Kalla, people who have diabetes
and feeling loss often need cushioned orthotics (or supports) to protect their
feet. Individuals must keep orthotics in mind when choosing and fitting a shoe.
6. Grip
Loss of balance often goes with feeling loss. Shoes with
low soles and a wide, stable heel can help, says Kalla. Sometimes heels need to
be flared outwards for more support. The shoe’s sole is also important, especially
in wet climates. Many therapeutic shoes have slippery soles, which are risky for
people with feeling and balance loss. Moore says that athletic shoes offer good
gripping outer soles. On the other hand, the outer soles of orthopedic footwear
often have no tread pattern. This smooth bottom may be good for people who shuffle
when they walk and trip easily in shoes with thick soles, but it is risky in wet
conditions. A fall may be worse than the original foot problem.
7.
Support
Dr. Jack E. Taunton, codirector of the Allan McGavin Sports Medicine
Centre at the University of British Columbia, says good shoes with extra arch
support, heel control and additional heel lifts are important for the older person,
as the aging foot loses strength and flexibility.
The International
Council on Active Aging thanks Phil Moore for providing this material. Moore has
written the Shoe Update, a review of footwear for the healthcare industry, since
1984. He also is coowner of LadySport Ltd. (1983), a retail chain that sells athletic
shoes and fitness gear.
Disclaimer:
This handout is not intended to replace a one-on-one relationship with a qualified
healthcare professional and is not intended as medical advice. It is intended
as a sharing of knowledge and information from research. The ICAA encourages you
to make your own health and business decisions based upon your research and in
partnership with a qualified professional. |
