Choosing shoes for diabetics.
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?
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:
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.
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.
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.
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.
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.
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.
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 information 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 qualified professional.