Which Shoes Do You Recommend For Diabetes

Pedors Classics & Classic Max

Stretch Walkers and Hiker



What is diabetes?

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.

Diabetes and Footcare

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.


What are Orthopedic Shoes?

The phrase “orthopedic shoes” or “orthopedic footwear” refers to the orthopedic design features of a shoe to relieve pain or pressure in the foot and sometimes in conjunction with the ankle.  Orthopedic shoes tend on the whole to be extra depth shoes designed to accommodate an orthotic device to help remedy a biomechanical deficiency in the foot. It could be that additional arch support is required in the shoe to help relieve plantar fasciitis. It could be that an accommodative insert is needed to help evenly distribute pressure on the plantar surface of the foot to relieve a pressure point.  It could be that a shoe is required that is big enough and wide enough to accommodate a device to stabilize the ankle joint by using an ankle foot orthoses, often called an AFO.  It could be that an orthopedic shoe is needed to enable a modification to be made to address leg length discrepancy where one leg is longer than the other causing pain in the hip alignment and lower back issues.  Orthopedic footwear is often a critical component to successfully treating a whole range of health issues that may start in the foot but lead to other problems throughout the body.

What are Diabetic Shoes?

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.

What are diabetic inserts?

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 are the features to look for in diabetic socks?

Just as it’s important to have the right diabetic shoe and diabetic insert,  if a bad sock is in play, the sock can cause damage that neither the shoe or insert can fix.  A good diabetic sock has several design features. Ideally it is seam free or has a flat seam that won’t irritate the foot. The sock fits well so it doesn’t bunch or gather in the shoe again causing a pressure point.  The top of the sock needs to be non binding but also needs to keep the sock in place. The materials used in the sock should be soft and  help wick moisture away from the foot. Antimicrobial components are considered important to avoid infection in the foot.


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