Shoes and Diabetes: What's on Your Feet Matters

When you have diabetes, you need to take special care of your feet. That's why it's important to check your feet daily and choose your shoes wisely. 

Wear well-fitting, comfortable shoes to help keep small foot problems -- like a corn, blister, or a callus -- from turning into severe ones.

Find the Right Size

If you haven't had your foot measured in a while, visit a shoe store to see what size you should wear, says podiatrist James Wrobel, DPM. Don't buy shoes that are too small or too big, which can cause blisters and calluses, he says.

About 6 out of 10 people with diabetes wear the wrong-size shoes, a study at the University of Dundee in the United Kingdom shows. Another study shows that only about one-fourth of all people wear the correct-size shoes.

Don't mistake a tight fit for good support, Wrobel says. Instead, wear shoes with comfortable support.

Tips to Pick the Right Shoe

Once you know your correct size:

1. Look for shoes that don't have pointed toes. Instead, choose ones with a spacious "toe box," so your toes have plenty of wiggle room. That way they won't be crushed together. You'll have less chance of corns, calluses, and blisters that can turn into ulcers.

2. If you can remove the shoe's insole, take it out and step on it. Your foot should fit comfortably on top of it with no overlap. If your foot is bigger than the insole, it will be crammed inside the shoe when you wear it. Choose a different shoe.

3. Avoid high-heeled shoes, because they put pressure on the ball of your foot. If you have nerve damage, you might not realize that area is sore or getting calluses. High heels can also cause balance issues, especially if you have nerve damage.

4. Steer clear of sandals, flip-flops, or other open-toe shoes. Straps can put pressure on parts of your foot, leading to sores and blisters. Open-toe shoes can make you prone to injuries like cuts. It's also easier for gravel and small stones to get inside them. These can rub against your feet, causing sores and blisters.

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5. Consider laced shoes instead of slip-ons. They often provide better support and a better fit.

6. Try on shoes at the end of the day. Your feet are more likely to be a little swollen. If shoes are comfortable when your feet are swollen, they should feel fine the rest of the time, too.

7. Don't buy shoes that aren't comfortable, planning to break them in as you wear them. Shoes should feel good when you first try them on. If you take off new shoes after wearing them a couple of hours and find red, tender spots, don't wear them again.

8. Buy at least two pairs with good support. Each pair will likely have different pressure points on your feet, so change your shoes daily. Your shoes will also get to dry and air out when you don't wear them every day.

9. In some cases, Medicare covers the cost of special shoes for people with diabetes. You must meet certain criteria, such as having changes in your foot shape, past foot ulcers, or calluses that can lead to nerve damage. A doctor needs to prescribe them. Talk to your foot doctor or primary care doctor to find out more.

Keep Your Shoes On

Once you find shoes that fit well, wear them all the time. Don't go barefoot, even around the house or pool areas. "Some patients, when they are numb, may walk on a piece of glass and not be aware of it," says podiatric surgeon Robert K. Lee, DPM.

Foot doctors suggest you put on shoes even if you just take a few steps to go to the bathroom in the middle of the night. There's always a chance you could step on something, not feel it, and injure yourself.

Enjoy Occasional Fancy Feet

Having diabetes doesn't mean you have to wear sensible shoes every day for the rest of your life.

"The need for being careful depends on how advanced the neuropathy is," Lee says. "The risks vary significantly depending on how advanced the disease is and how numb or how bad circulation is."

If you have normal feeling and blood flow, it might even be OK to wear dressy shoes like high heels or pointy wing-tips for short periods of time, Lee says. Ask your foot doctor what's best for your feet, though.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on May 18, 2019

Sources

SOURCES:

American Diabetes Association: "Living With Diabetes: Foot Complications."

Harrison, S. The International Journal of Clinical Practice, Oct. 10, 2007.

Nixon, B. Journal of the American Podiatric Medical Association, July/August 2006.

FamilyDoctor.org: "Diabetic Neuropathy."

Medicare: "Diabetic Shoes."

James Wrobel, DPM, associate professor of internal medicine, University of Michigan Medical School.

Robert K. Lee, DPM, podiatric surgeon, UCLA.

American College of Hyperbaric Medicine: "Diabetic Foot Ulcer."

Joslin Diabetes Center, Harvard Medical School: "The Best Shoes for People With Diabetes."

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