Diabetes and Shoes: What are the key features of Diabetic Shoes?
In 1993 Congress enacted a bill known as the Therapeutic Shoes for Individuals with Diabetes. The Bill recognizes that Diabetics who may have peripheral neuropathy are at risk for factors that can lead to an ulceration and possibly amputation. Appropriate Diabetic Shoes and Diabetic Inserts help to minimize those risks.
Therapeutic footwear is regarded as a generic term for footwear that is designed to allow some form of treatment and may refer to both custom-made or pre-fabricated medical grade footwear.
However, in order to be considered as appropriate footwear for Diabetics certain design criteria need to be met. The shoe needs to accommodate the foot in such a way that there is plenty of room in the toe box The insole needs to be at least 3/16th’s of an inch thick and removable in order to accommodate a custom or prefabricated diabetic insert. The diabetic shoe needs to be available in full and half sizes and available in a minimum of three widths. Further the outsole needs to be graded to the upper, again in at least three distinct widths. The shoe needs to have a closure to ensure the shoe stays on the foot in order to protect it.
12 Key features of Diabetic Shoes
- Soft, preferably seamless, upper material
- Strechable or moldable upper
- Wide deep toe box
- Full and half sizes and multiple widths.
- Removable insole
- Adjustable closure
- Stable wide midfoot
- Soling graded to upper
- Toe Spring
- Delayed Heel Strike
- Ideally machine washable.
More on other design features on shoes for swollen feet here
Another key design feature is that internal seams should be avoided as would anything else internal to the shoe that could cause rubbing, a blister or some other injury to the insensate diabetic foot. Further, the upper material should be soft, seamless and moldable to accommodate a deformity like a bunion or a hammer toe.
Diabetic shoes are usually extra-depth footwear that defines how a shoe is constructed with additional depth and volume in order to accommodate deformity such as claw/ hammer toes and/or to allow for space for a thick multi-density diabetic insert. Usually a minimum of 5 mm (~3/16″) depth is added when compared to normal footwear. Even greater depth is sometimes provided in footwear which is referred to as double depth or super extra-depth. And so by accommodating a custom insert or orthotic or some other device like a custom ankle foot orthotic (AFO) the diabetic shoe becomes an integral part of an orthopedic device.