Importance of footwear in Diabetes

Tips to keep in mind when buying your footwear Sandals

• For everyday use, wear sandals with a heel counter (a piece of leather forming the back of the sandal). A good heel counter helps to lock the foot in place by providing adequate support to the ankle.

• Velcro fitting sandals are more apt for people with diabetic peripheral neuropathy.

• Make sure that the outer sole is tough and the inner sole is smooth as this balances the pressure exerted by body weight.

• Sandals should be comfortable and not too tight while trying them on or walking.

• The front part of the sandal should be wide to prevent friction or crowding of the toes. Crowding of toes can also give rise to fungal infection between the

toes.

• It is advised to wear cotton socks to reduce friction between the foot and the footwear. Also, socks help in absorbing sweat, which is particularly important as a moist environment inside the footwear tends to invite an array of infections.

• Use of high heels should be avoided, as your weight tends to shift to the front of the ball of the feet inducing pain. It is preferable to use a heel height of 1 inch or less (but not in people with existing peripheral neuropathy.)

Shoes

• Select shoes with a wider toe box (front part of a shoe), to accommodate all five toes without pressing or compressing

so that they are not restricted to function.

• Opt for shoes with Velcro fitting instead of laces as this aids in improving adjustability especially in people who have neuropathic oedema (swelling).

• Ensure that the back of the shoe, i.e. heel counter, is rigid yet flexible.

• Keep in mind that the overall measurement of the foot length should be from the heel to the longest toe. Therefore, you should allow a 1h inch space between the longest toe and the end of the shoe.

• Check the positioning of the toes and foot. Ensure that they don't rub against the shoe.

• Look for a comfortable fit around the heel.

• Ensure that the tongue of the shoe is foam-padded.

• While buying sports shoes, make sure that they have adequate width so that the entire foot is nestled comfortably and provides a good grip.

• As both the foot may not be identical, it is always better to try each shoe individually and see that you can walk properly without any pain or discomfort.

• Shoes made of leather or materials that mould to the shape of your feet are ideal as they allow the skin to breathe.

• You can also opt for ankle-high leather boots as these stabilise and control rotation at the ankle.

• Avoid shoes with tight fittings, metal eyelets and a pointed or narrow toe box.

• Prefer shoes with low wide heels as they are more comfortable and provide stability while walking thereby preventing falls.

KV Kavitha is a Consulting Podiatrist.