First, let’s deal with the question: Do you need special footwear if you have diabetes? “People with long-standing diabetes have a loss of sensation in the foot, a condition we call neuropathy,” says Dr V Mohan, founder of Dr Mohan’s Diabetes Specialities Centre in Chennai. “In extreme cases, they may not feel anything in the foot even if a thorn or nail pierces it. Which is why, it becomes necessary for them not to walk barefoot as much as possible.” Moreover, he points out, the blood circulation in the feet is also decreased. So if you’ve got diabetes, it’s best to invest in footwear that reduces the pressure under the feet. Here’s what you should keep in mind.
Shoe shape
“The shoe should be broad, especially in the front. Narrow or pointed shoes will not do. I’d recommend a shoe half or one size bigger,” says Dr Mohan. If the shoes are not wide enough, the feet will rub against the sides of the shoe, causing blisters and calluses. The reason you should be more aware of this, is that when you have neuropathy, you will not be able to feel whether your shoes are causing you damage. “If there are foot deformities already, you need customised shoes, made to order, after taking the correct measurements,” he says. Additionally, once you identify the pressure points under the foot (your doctor may ask you to bring in your old shoes so he can see the wear-and-tear), you can modify the shoe by adding a layer of material at that spot to off-load the pressure.
Sole mates
While the sole of the shoe needs to be firm, “the insole should be soft and made up of special material like microcellular rubber or microcellular plastic or plastazote,” he says. The shoes must be replaced as soon as the insole wears out. Adds diabetologist Dr Ranjit Unnikrishnan, “The soles should be stitched and not nailed on to the shoes.”
Sandal choices
If you choose to wear sandals, and not shoes, select ones with a backstrap that holds your feet in place. “This prevents the need for you to put pressure and hold the sandal with your toes,” he says. Be careful of velcro, as that can also scrape against the foot. “Slippers with two prongs should be avoided.” And “use cotton socks with your shoes, preferably ones without elastic,” says Dr Unnikrishnan.
Pay attention
You also need to be extra careful with a few other things when it comes to daily podiatry care. “Wash and moisturise your feet daily, but keep the web spaces dry,” says Dr Unnikrishnan. Avoid extreme temperatures: water that’s too hot or too cold, or walking on extreme surfaces. Don’t sit cross-legged for a long time either. Inspect your feet daily, and check in with your doc for regular foot exams.
