Sunday, March 03, 2024
DIABETES Diabetic Foot Problems

Surprising Benefits of Diabetic Shoes and Orthotics 

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If you have diabetes with neuropathy in your feet, diabetic shoes and orthotics can be immensely beneficial. Many people wear the wrong shoes, however for diabetics, wearing the correct footwear is very important. This is because incorrect footwear can cause diabetics to develop foot wounds that can become infected. This, in turn, can lead to amputation.

In this article, we’ll discuss in detail the benefits of diabetic shoes and orthotics. 

Let’s dive in…

woman checking blood sugar levels

How Does Diabetes Affect Your Feet?

If you have elevated blood sugar levels, nerve damage can occur. The symptoms of nerve damage include numbness, tingling, and burning sensations. These are some of the “sensory” effects of neuropathy.  

One of the other effects of diabetes is motor neuropathy. This can cause the muscles of your feet to become affected. Motor neuropathy can change the structure of your feet by causing certain foot deformities to occur such as bunions and hammertoes. Not only that, pressure on the bottom of your forefoot can increase. This can increase your risk of developing an ulcer in the area. 

In addition, autonomic neuropathy symptoms can be present in the diabetic foot. This includes dryness of the skin on the feet. You may notice that your heels tend to crack.  

To read more about cracked heels and how you should treat them, check out this supplemental post. 

Due to the foot changes that can occur from diabetes, wearing improper shoe gear can cause further problems. 

diabetic shoes

What Are the Benefits of Diabetic Shoes?

Diabetic Shoes Have a Deep Toe Box

Say for instance you have hammertoes (bent toes). Wearing shoes with a tight toe box with no wiggle room for your toes can cause painful corns and even ulcers to occur due to constant rubbing of the top of the shoes against the toes when walking. 

Many standard shoes have a narrow and shallow toe box. The average toe box, 5cm from the tip of a shoe, is 44mm deep. 

Diabetic shoes are designed to have a deep toe box to allow room for toe deformities such as hammertoes, crossover toes, and amputated toes. 

Diabetic Shoes Are Wide and Supportive

Diabetic shoes are often wide enough to support many foot deformities. Many diabetics have wide feet due to bunions and bunionettes. If they wear shoes that are too narrow, they can easily develop ulcers at the bunion sites due to the inability to feel sensations in the feet. 

When you get fitted for diabetic shoes, your feet will be measured for length and width. Your feet will be measured using a Brannock device. Make sure to get fitted for diabetic shoes at the end of the day when your feet are the most swollen. 

Diabetic Shoes Are Extra-Depth

The actual diabetic shoe itself is usually extra-depth. This is important because it provides the foot with stability in addition to accommodating foot deformities. 

Extra-depth shoes can help prevent your foot from sliding off your shoe when walking. Not only that, it avoids constrictive pressure that you may feel on your ankle from a standard shoe. 

Another reason diabetic shoes need to be extra-depth is that it needs to be able to fit a custom diabetic orthotic inside of the shoe. This is important because diabetic shoes and orthotics together are greatly beneficial in preventing ulcers. 

diabetic shoes with diabetic orthotics

Diabetic Shoes Are Made of Durable and Breathable Materials

Diabetic shoes are made of materials that are durable and breathable, like leather and canvas. These materials are not constrictive and provide flexibility and support to the feet. 

Diabetic Shoes Have a Firm Heel Counter

The back portion of your shoe that helps stabilize your heel is the heel counter. Diabetic shoes have a firm heel counter with a padded collar that helps provide the heel with stability while walking. Not only that, a firm heel counter can help prevent blister formation. 

Diabetic Shoes Have a Sturdy Sole

Diabetic shoes have a lightweight but sturdy sole. This can help prevent falls. Not only that, some diabetic shoes have rocker soles. These rocker bottom soles can help unload pressure on the forefoot. Forefoot ulcers are common due to bone prominences. The rocker can help prevent the formation of these ulcers by reducing pressure in the area. 

Diabetic Shoes Don’t Have Prominent Seams Inside Them

Even small things like seams on the insides of the shoes can cause a blister or sore to form in diabetic neuropathic feet. This is because the person wearing the shoes cannot feel the seam aggravating the skin. Many diabetic shoes have minimal or no seams on the inside. This can help protect sensitive skin. 

diabetic shoes with laces and no tie laces

Diabetic Shoes Offer Velcro and No-tie Laces

A lot of people with diabetes have neuropathy. This can make tying shoes difficult. Diabetic shoes offer Velcro and no-tie lace options. This can be helpful for neuropathic patients.

diabetic plastazote orthotics

What Are the Benefits of Diabetic Orthotics?

Diabetic orthotics can help reduce pressure points in specific areas of the foot by dispersing pressure throughout the foot. This, in turn, can help prevent blisters and ulcerations from forming in the foot. 

Diabetic orthotics can be custom-made to your feet. Diabetic orthotics are often made from Plastazote material. This is a type of polyethylene foam. This material is stiff, resistant to deforming forces, and supportive. 

Custom orthotics can be multi-layered and thus multi-density, which helps with added shock absorption. Not only that, extra padding can be added to the insert to offload a painful wound.

How Often Should Diabetic Shoes Be Replaced?

In general, diabetic shoes can be replaced yearly per Medicare guidelines. However, when exactly diabetic shoes will need to be replaced depends on how often the person wears the shoes. Check the bottoms and insides of your shoes monthly. If there is significant wear and the shoes are no longer supportive, the shoes should be replaced. 

How Often Should Diabetic Orthotics Be Replaced?

In general, diabetic plastazote orthotics should be replaced every 3 months, assuming the person is wearing the inserts daily. However, if there is excess wear on the orthotics, they should be replaced more often. 

How Much Are Diabetic Shoes?

Diabetic shoes can vary from $60 to $300 plus a pair, depending on where you buy them. If you are a diabetic with neuropathy, it’s best to call your insurance to see if diabetic shoes and orthotics would be covered. If they are covered, call your local foot doctor to inquire whether you can obtain a prescription for them. 

Can Diabetics Wear Flip-Flops?

Diabetics should avoid wearing flip-flops since flip-flops provide no significant support to the feet. In addition, many diabetics suffer from neuropathy. Flip flops leave your toes and back of your feet exposed. If you have numbness in your feet, this can place you at a higher risk for developing sores and injuries. 

Conclusion

In conclusion, diabetic shoes and orthotics can be greatly beneficial in preventing complications that can be present in the diabetic foot. Even if you had ulceration in your foot in the past, diabetic shoes and orthotics can help prevent it from recurring. Make sure you talk to your foot doctor about the right footwear options for you. 

Related article: Diabetic Socks Benefits- What Is the Benefit of Diabetic Footwear?

Do you have diabetic shoes and orthotics? Are they beneficial? I would love to hear your thoughts! Leave a comment below!

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References

  1. Busch, K., & Chantelau, E. (2003). Effectiveness of a new brand of stock ‘diabetic shoes to protect against diabetic foot ulcer relapse. A prospective cohort study. Diabetic medicine20(8), 665-669.https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-5491.2003.01003.x
  2. Uccioli, L., Faglia, E., Monticone, G., Favales, F., Durola, L., Aldeghi, A., … & Menzinger, G. (1995). Manufactured shoes in the prevention of diabetic foot ulcers. Diabetes care18(10), 1376-1378.https://diabetesjournals.org/care/article/18/10/1376/18733/Manufactured-Shoes-in-the-Prevention-of-Diabetic
  3. Elraiyah, T., Prutsky, G., Domecq, J. P., Tsapas, A., Nabhan, M., Frykberg, R. G., … & Murad, M. H. (2016). A systematic review and meta-analysis of off-loading methods for diabetic foot ulcers. Journal of vascular surgery63(2), 59S-68S.https://www.sciencedirect.com/science/article/pii/S0741521415020285
  4. Maciejewski, M. L., Reiber, G. E., Smith, D. G., Wallace, C., Hayes, S., & Boyko, E. J. (2004). Effectiveness of diabetic therapeutic footwear in preventing ulceration. Diabetes care27(7), 1774-1782.https://diabetesjournals.org/care/article/27/7/1774/24763/Effectiveness-of-Diabetic-Therapeutic-Footwear-in
  5. Jarl, G., Alnemo, J., Tranberg, R., & Lundqvist, L. O. (2019). Gender differences in attitudes and attributes of people using therapeutic shoes for diabetic foot complications. Journal of Foot and Ankle Research12(1), 1-7.https://link.springer.com/article/10.1186/s13047-019-0327-0
  6. Mohamed, Olfat PhD, PT; Cerny, Kay PhD, PT; Rojek, Loren CPO; Herbert, Krista BS; Turner, Rebecca BS; Waistell, Sean BS. The Effects of Plastazote® and Aliplast®/Plastazote® Orthoses on Plantar Pressures in Elderly Persons With Diabetic Neuropathy. JPO Journal of Prosthetics and Orthotics: April 2004 – Volume 16 – Issue 2 – p 55-63.https://journals.lww.com/jpojournal/fulltext/2004/04000/the_effects_of_plastazote__and.5.aspx
  7. Munro, W. (2005). Orthotic prescription process for the diabetic foot. The Diabetic Foot8(2), 72-82.http://algeosmedia.s3.amazonaws.com/Product/Diaped/Research/orthotic_prescription_process_for_the_diabetic_foot.pdf
  8. Reddy, P. V., Vaid, M. A., & Child, D. F. (1989). Diabetes and incorrectly fitting shoes. Practical Diabetes International6(1), 16-16.https://onlinelibrary.wiley.com/doi/abs/10.1002/pdi.1960060109
  9. Uccioli, L., & Giacomozzi, C. (2009). Biomechanics and choosing footwear for the diabetic foot. Diabetic Foot12(4).http://algeosmedia.s3.amazonaws.com/Product/Diaped/Research/biomechanics_and_choosing_footwear_for_the_diabetic_foot.pdf
  10. Pratt, D. J., Rees, P. H., & Rodgers, C. (1986). Assessment of some shock absorbing insoles. Prosthetics and Orthotics International10(1), 43-45.https://www.tandfonline.com/doi/abs/10.3109/03093648609103079
  11. Gerrard, J. M., Bonanno, D. R., Whittaker, G. A., & Landorf, K. B. (2020). Effect of different orthotic materials on plantar pressures: a systematic review. Journal of foot and ankle research13(1), 1-11.https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-020-00401-3
  12. Lavery, L. A., Vela, S. A., Fleischli, J. G., Armstrong, D. G., & Lavery, D. C. (1997). Reducing plantar pressure in the neuropathic foot: a comparison of footwear. Diabetes care20(11), 1706-1710.https://diabetesjournals.org/care/article/20/11/1706/21189/Reducing-Plantar-Pressure-in-the-Neuropathic-Foot
  13. Brodsky, J. W., Brajtbord, J., Coleman, S. C., Raut, S., & Polo, F. E. (2012). Effect of heating on the mechanical properties of insole materials. Foot & ankle international33(9), 772-778.https://journals.sagepub.com/doi/abs/10.3113/fai.2012.0772

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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