Shoes are important for patients with diabetes. Poor fitting shoes have been associated with sores on the feet called ulcers. Podiatrists, family doctors, vascular surgeons, nurses, patients, and even politicians despise foot ulcers. This is because ulcers lead to infection, limb amputation, and can be very expensive to treat.
So, what exactly is a diabetic shoe? A diabetic shoe is sometimes called an extra depth shoe or an orthopedic shoe. These shoes are designed with enough depth to accept a shoe insole without your foot or toes feeling crowded. Also, they have extra room in the toe box to accommodate bunions or hammer toes.
There are many different types of diabetic insoles that can be placed in a diabetic shoe. Most are made from multi-density foam produced from a mold of the patient's foot. These insoles increase contact with the patient's arch when walking. The increase in contact surface is associated with a decrease in pressure to the skin. I have confirmed these using F-scan pressure testing insoles. Decreasing pressure points on the foot help prevent the skin from breaking down to form an ulcer.
Not everybody with diabetes needs a diabetic shoe with special insoles. Diabetic shoes are indicated for patients with foot deformity, poor circulation, difficulty feeling their feet (neuropathy), a history of foot sores (those dreaded ulcers again), and calluses that may cause the skin to break down over time.
Many brands of shoes now have extra depth models for diabetic patients: Dr. Comfort, New Balance, Hush Puppies, Drew, Soft Spots, etc. They are available in a variety of styles with laces and Velcro straps. Some of the newer shoes feature light weight design.
A major concern with diabetic shoes is compliance. Some patients don't wear their shoes enough to make a positive difference in their treatment outcome. They take off their shoes to walk barefoot at home or they don't like how the extra depth feels "too roomy" or "clunky". Medicare limits diabetic shoes to one pair per year. Yet, how many people can get by with just one shoe? This isn't realistic for active patients and these patients should have more than one pair.
Diabetic patients with severe deformity may require a custom shoe, which is made from a casting of the foot. These shoes are built around the cast of the foot and also work well to accommodate braces that extend from the foot across the ankle (ankle foot orthotics).
In summary, diabetic shoes are indicated mainly for high risk patients. Diabetic shoes shouldn't be viewed as one outspoken patient bluntly stated, "free government shoes." They work mainly by reducing pressure points to prevent amputation and limb loss.
Technorati tags: Diabetes, Type 1, Type 2, Gestational, Shoes, Foot, Ulcers, Sores.
Blogalaxia tags: Diabetes, Type 1, Type 2, Gestational, Shoes, Foot, Ulcers, Sores.