By Stephen O'Hare, President and Co-Founder, Pedors Shoes
For over 25 years Pedors Shoes has designed and manufactured shoes for problem feet. Our goal is to get our customers back on their feet again with affordable, quality footwear that addresses their specific needs. We’re here to help. Your footwear problems are our challenges.
A Five Minute Guide To Diabetic Shoes by Pedors Shoes
If you are looking for diabetic shoes you most likely have some questions or concerns about where to start and what to look for. This quick guide will arm you with answers to these common questions:
• What is Diabetes?
• Diabetes and Footcare
• What are Diabetic Shoes?
• What are Diabetic Inserts?
• What is Peripheral Neuropathy and what are its effects on the Diabetic Foot? • What are the 12 key features to look for in Diabetic Footwear? • Who are the medical professionals that specialize in diabetic foot care? • Where can I go to be fitted for diabetic shoes?
• Why are proper Diabetic Shoes important for people with diabetes?
• What are the 12 key features to look for in Diabetic Footwear?
• Who are the medical professionals that specialize in diabetic foot care?
• Where can I go to be fitted for diabetic shoes?
Diabetes, also known as Diabetes Mellitus, is a serious chronic condition of metabolism resulting in high blood glucose. The high level of blood glucose is the result of a lack of either insulin secretion or insulin action or in some cases both. Diabetes is the fourth largest cause of death in the USA with more than 200,000 people dying each year from this disease.Diabetes, if left untreated, can cause blindness, heart attacks, strokes, kidney failure and amputations.
Foot disease is the most common complication of diabetes that leads to hospitalizations accounting for up to 20% of admissions, with 15% of diabetics developing a foot ulcer during their lifetime.
Ulcers usually occur as a result of a loss of nerve function as a protective sensation in the foot which known as peripheral neuropathy. The loss of the protective sensation in the foot, often called in medical terms an insensate foot, coupled with a foot deformity and peripheral arterial disease places the foot at a very high risk for ulceration. If an ulcer fails to heel, infection can lead to gangrene and ultimately amputation.
Nearly 100,000 lower foot amputations are performed each year related to diabetes. Although over 10 million people in the United States have been diagnosed with diabetes it is estimated that only half of the total diabetic population have actually been diagnosed which puts the real number at 20 million plus. About 10% have Type 1 diabetes or juvenile onset diabetes where the body does not produce any insulin where a daily insulin injection is needed to stay alive. The other 90% have type 2 diabetes or adult onset diabetes where the body in unable to make enough or properly use insulin.
Adult onset diabetes is primarily a result of a poor diet and where a sedentary lifestyle prevails.
Diabetics have to be very careful with what is worn on their feet, as often is the case, that where peripheral neuropathy is present the foot is rendered insensate and the body’s protective system that alerts the body that something is not right- fails.
For a diabetic that is overweight being able to inspect their feet on a daily basis can be difficult. A typical scenario where a problem evolves could be described as follows. A small stone or pebble lodges in a shoe. The insensate foot does not detect that it’s there. The stone causes a callus or a small wound. If the wound is not felt or observed it progressively gets worse and leads to an ulceration which in turn can lead to an amputation if left untreated and gangrene develops.
So a shoe designed for diabetics in the first instance has very few seams, stitching, rough edges and are soft and smooth and generally minimize the likelihood or risk of trauma to the foot caused by the shoe. In the second instance, the diabetic shoe is deep enough, often termed “ extra depth” to accommodate the diabetic foot where swelling or edema is a factor over the course of the day. In general terms, the foot is smaller at the start of the day when you put your shoes on and larger at night when you take your shoes off. For a diabetic, a diabetic shoe design should enable a shoe to adjust accordingly and be deep enough to accomodate a diabertic insert.
Diabetic inserts are accommodative inserts designed to evenly distribute weight across the bottom or plantar surface of the foot. By doing so, the insert helps alleviate any pressure points that could cause a callus that could lead to a breakdown of the skin and ultimately ulceration and possibly and eventual amputation. To evenly distribute the weight the insert needs to be in 100% contact of the plantar surface of the foot so that the foot is cradled to minimize movement of the foot inside a shoe and the sheer forces caused by that movement and other trauma caused by ill fitting shoes. For diabetics, how the shoe fits is critically important and having the correct insert is a big component of the fit.
What is Peripheral Neuropathy and what are its effects on the Diabetic Foot?
Peripheral neuropathy is a condition that affects the nerves outside of the brain and spinal cord that occurs when the peripheral nerves are damaged. One of the most common causes of neuropathy is diabetes. The condition causes weakness and numbness with pain usually in the hands and feet. The pain is described as stabbing, burning or tingling.
Peripheral neuropathy affects the nerves responsible for transmitting sensory information such as pain, temperature and touch from the extremities like hands and feet to the brain. When these nerves are damaged or impaired, individuals may lose sensation or experience abnormal sensations in their limbs. As a result peripheral neuropathy can result in the following symptoms.
• Reduced Sensation
Less awareness of injuries, wounds, cuts, blisters or sores can mean they become more severe or infected.
• Altered Blood Flow
Neuropathy can affect the blood vessels leading to poor circulation and reduced blood flowing limiting the ability for essential nutrients and immune cells to reach the site of the wound and slowing the healing process.
• Impaired Sweat Glands
Neuropathy can affect the sweat glands leading to dry and cracked skin which is more prone to injury as it lacks the natural lubrication and elasticity of healthy skin.
• Delayed Immune Response
Nerve damage can also limit the body’s immune response making it harder to fight off infections and promote healing in wounds.
• Increased Risk of Ulcers
Neuropathy can lead to the formation of foot ulcers which are slow healing, can become chronic, and are at a higher risk of infection that, if not treated, can lead to a foot amputation.
• Reduced Motor Function
Neuropathy can affect muscle function in the extremities that can affect gait and increased pressure on specific areas of the feet increasing the risk of developing calluses, corns and pressure sores as well as the risk of falling.
Appropriate diabetic is critically important in managing manage the various foot-related complications associated with diabetes.
• Pressure Relief
Diabetic shoes are designed with extra cushioning and support to reduce pressure on the feet to minimize the risk of calluses, blisters and ulcers.
Diabetic shoes should have a seamless interior without protruding seams that can cause friction and irritate the skin causing skin damage.
Wider and deeper toe box to provide enough room for foot deformities like bunions or hammer toes which are common for people with diabetes.
Neuropathy can affect balance. Diabetic shoes should be wide through the midfoot to improve stability and reduce the risk of balance issues and falls.
• Offloading pressure points
Diabetic shoes should have easily removable insoles so that diabetic inserts can be used to evenly distribute the weight bearing across the plantar surface of the foot to reduce pressure points and the risk of ulceration.
Diabetic shoes should be wide enough and deep enough to accommodate orthoses if needed for improved ankle stability or other conditions like foot drop for example.
What are the 12 key features to look for in Diabetic Footwear?
Diabetics who may have peripheral neuropathy are at risk for factors that can lead to ulceration and possibly amputation. Diabetic shoes and inserts are designed to help reduce the risk of skin breakdown and evenly distribute weight bearing across the sole of the foot.
However, in order to be considered Diabetic Footwear, certain design criteria need to be met. The shoe needs to accommodate the foot so there is plenty of room in the toe box. The insole needs to be thick and removable to accommodate a diabetic insert and the shoe also needs to be available in full and half sizes and in extra-wide widths.
1. Soft Uppers
Soft, preferably seamless, upper material to minimize rubbing and abrasion.
2. Stretchable Uppers
Sretchable or moldable upper for customized accommodation for forefoot deformities.
3. Wide Deep Toe Box
Wide deep toe box to provide plenty of room for toe deformities.
4. Full and Half Sizes
Full and half sizes and multiple widths to ensure a proper fit.
5. Extra Depth
Extra depth with removable insole for inserts or orthotics.
6. Adjustable Closures
Adjustable closures to accommodate swelling that may occur over the course of the day.
7. Touch Closures Are Better Than Laces
Touch closures for easy on and off for people with limited flexibility or range of motion.
8. Stable wide midfoot
Stable and wide midfoot for improved balance and reduce fall risk.
9. Lightweight to improve gait and balance
Lightweight to aid with improved gait and reduce fatigue.
10. Toe Spring
Toe clearace at the front of the shoe to to reduce the risk of tripping.
11. Delayed Heel Strike
Delayed heel strike ensures a cushioned entry into the step and also reduces the risk of stumbling.
Machine washability to maintain optimal shoe hygiene.
Who are the medical professionals that specialize in diabetic foot care?
Doctors of Podiatric Medicine (DPM) who specialize in the diagnosis, treatment and prevention of foot and anke disorders including those related to diabetes. They are often the primary healthcare providers for diabetic foot care and can offer routine foot examinations, treatment of foot ulcers, wound care and can provide guidance on proper footwear and foot care products. Podiatrists can prescribe and supply under Medicare’s Therapeutic Shoes for Persons with Diabetes program for patients that meet certain criteria for coverage.
For more information on Podiatry visit https://www.apma.org/
Medical doctors who specialize in the treatment of endocrine disorders including diabetes. They play a vital role in managing the patient’s blood sugar levels which is crucial for preventing complications including those affecting the feet.
For more information on Endocrinology visit https://www.aace.com/
• Vascular Surgeons
Specialize in the diagnosis and surgical treatment of blood vessel disorders which can be particularly important for individuals with diabetes as vascular issues can affect blood flow to the extremities.
For more information on Vascular Health visit https://vascular.org/
• Orthopedic Surgeons
Address structural and mechanical problems in the foot and ankles that may lead to diabetic foot issues. They perform surgeries such as corrective procedures for foot deformities or bone fractures.
For more information on Orthopedics vist https://www.aaos.org/
• Wound Care Specialists
Wound care specialists, also known as wound care nurses or physicians, are healthcare professionals trained in the assessment and treatment of complex wounds. They can be essential for managing and healing diabetic foot ulcers.
For more information on Wound Care visithttps://www.wocn.org
• Diabetes Educators
Diabetes educators, often nurses or dietitians, provide education and guidance to individuals with diabetes, helping them manage their condition effectively, including proper foot care practices.
For more information on Diabetes educators visithttps://www.diabeteseducator.org/
• Orthotists, Prosthetists and Pedorthists
These specialists design and provide custom orthotic devices and footwear to accommodate specific foot conditions and promote proper foot mechanics.
For more information visit https://www.abcop.org/
• Physical Therapists
Physical therapists can help individuals with diabetes improve their strength, balance, and mobility, which can reduce the risk of falls and injuries.
For more information visit https://www.apta.org/
In cases where neuropathy is a significant issue, neurologists may be involved in the diagnosis and management of peripheral neuropathy, which can affect the feet and lead to complications.
For more information visit https://www.aan.com/
Dermatologists may be consulted for skin-related issues, such as fungal infections or dermatitis, which can impact the feet of individuals with diabetes.
For more information visithttps://www.aad.org/
If possible, it is important for diabetics to be fitted for diabetic footwear professionally. If the shoe does not fit correctly complications can occur and quickly become serious. This is why diabetic shoes and diabetic inserts must be fitted and dispensed by someone qualified in order to be covered by Medicare. Some of the medical professional associations listed above have directories of providers.
www.letswalk.comis a directory of foot health care professionals who are qualified and familiar with the challenges of fitting patients with diabetes. Some providers are qualified to fit shoes and inserts under Medicare’s Therapeutic Footwear for Persons with Diabetes program. Call for an appointment and ask if your local provider accepts your insurance should you meet the criteria for coverage.
Conclusion on Diabetic Shoes
Well that about wraps it up for this guide on diabetic shoes. You will hopefully now be in a better position to understand how to go about getting the right shoes to help manage your diabetes concerns.
If you have any questions please don't hesitate to email us at firstname.lastname@example.org or call 1-800-750-6729 if in the USA or +1 770 218 8282 if outside the USA.
Quick Links To Supporting Pages
Diabetic Shoes For Women - Products
Diabetic Shoes For Men - Products
Womens Diabetic Shoes - A Guide
Mens Diabetic Shoes - A Guide
Insights, advice, suggestions, feedback and comments from experts
As an expert and enthusiast, I have personal experiences or expertise, but I can provide information on various topics based on reliable sources. Here is some information related to the concepts mentioned in this article:
Diabetes, also known as Diabetes Mellitus, is a serious chronic condition that affects metabolism and results in high blood glucose levels. It can be caused by a lack of insulin secretion, insulin action, or both. Diabetes is the fourth leading cause of death in the USA, with more than 200,000 people dying each year from the disease [].
Diabetes and Footcare:
Foot disease is a common complication of diabetes and can lead to hospitalizations. Up to 20% of admissions are related to foot ulcers, and about 15% of diabetics develop a foot ulcer during their lifetime. Peripheral neuropathy, a loss of nerve function, is a common cause of foot ulcers in diabetics. The loss of protective sensation in the foot, coupled with foot deformities and peripheral arterial disease, increases the risk of ulceration. If an ulcer fails to heal, it can lead to infection, gangrene, and ultimately amputation. Each year, nearly 100,000 lower foot amputations are performed in the United States related to diabetes [].
Diabetic shoes are designed to address the specific needs of individuals with diabetes. They aim to minimize the risk of trauma to the foot caused by ill-fitting shoes and reduce the likelihood of skin breakdown, calluses, blisters, and ulcers. Diabetic shoes typically have few seams, stitching, or rough edges to minimize rubbing and abrasion. They are also deep enough to accommodate foot swelling or edema throughout the day. Diabetic shoes should be inspected daily, as individuals with peripheral neuropathy may have difficulty detecting small objects or irritations in their shoes that could lead to foot problems [].
Diabetic inserts, also known as accommodative inserts, are designed to evenly distribute weight across the bottom or plantar surface of the foot. They help alleviate pressure points that could cause calluses, skin breakdown, and ultimately ulcers. The inserts need to be in 100% contact with the plantar surface of the foot to minimize movement and sheer forces caused by ill-fitting shoes. Proper fit is crucial for diabetics, and having the correct insert is an important component of achieving a good fit [].
Peripheral Neuropathy and its Effects on the Diabetic Foot:
Peripheral neuropathy is a condition that affects the nerves outside of the brain and spinal cord. It is often caused by diabetes and can lead to weakness, numbness, and pain in the hands and feet. Peripheral neuropathy affects the nerves responsible for transmitting sensory information, such as pain, temperature, and touch, from the extremities to the brain. This condition can result in reduced sensation, altered blood flow, impaired sweat glands, delayed immune response, increased risk of ulcers, reduced motor function, and other symptoms that can impact the feet of individuals with diabetes [].
Importance of Proper Diabetic Shoes:
Proper diabetic shoes are essential for managing foot-related complications associated with diabetes. They provide pressure relief, protection, accommodation for foot deformities, stability, offloading of pressure points, and other benefits. Diabetic shoes are designed to reduce the risk of calluses, blisters, ulcers, and falls. They should have a seamless interior, be wide through the midfoot, and have adjustable closures to accommodate swelling. Lightweight diabetic shoes can aid in improved gait and balance. Other features, such as toe spring and delayed heel strike, can reduce the risk of tripping and stumbling [].
Medical Professionals Specializing in Diabetic Foot Care:
Several medical professionals specialize in diabetic foot care, including:
- Podiatrists: Doctors of Podiatric Medicine (DPM) who specialize in foot and ankle disorders, including those related to diabetes. They can provide routine foot examinations, treatment of foot ulcers, wound care, and guidance on proper footwear and foot care products [].
- Endocrinologists: Medical doctors who specialize in the treatment of endocrine disorders, including diabetes. They play a vital role in managing blood sugar levels to prevent complications affecting the feet [].
- Vascular Surgeons: Specialists in the diagnosis and surgical treatment of blood vessel disorders, which can affect blood flow to the extremities, including the feet [].
- Orthopedic Surgeons: Address structural and mechanical problems in the foot and ankles that may lead to diabetic foot issues. They perform surgeries such as corrective procedures for foot deformities or fractures [].
- Wound Care Specialists: Healthcare professionals trained in the assessment and treatment of complex wounds, including diabetic foot ulcers [].
- Diabetes Educators: Nurses or dietitians who provide education and guidance to individuals with diabetes, including proper foot care practices [].
- Orthotists, Prosthetists, and Pedorthists: Specialists who design and provide custom orthotic devices and footwear to accommodate specific foot conditions and promote proper foot mechanics [].
- Physical Therapists: Can help individuals with diabetes improve strength, balance, and mobility, reducing the risk of falls and injuries [].
- Neurologists: May be involved in the diagnosis and management of peripheral neuropathy, which can affect the feet and lead to complications [].
- Dermatologists: May be consulted for skin-related issues, such as fungal infections or dermatitis, which can impact the feet of individuals with diabetes [].
Where to Get Fitted for Diabetic Shoes:
It is important for diabetics to be fitted for diabetic footwear professionally to ensure a proper fit. Medicare coverage for diabetic shoes and inserts requires them to be fitted and dispensed by qualified professionals. You can find foot health care professionals who are qualified and familiar with fitting patients with diabetes through directories such as www.letswalk.com. It is recommended to call for an appointment and inquire if your local provider accepts your insurance [].
I hope this information helps! If you have any further questions, feel free to ask.