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When you have diabetes, selecting new shoes is about more than style. The right footwear can help prevent and relieve some foot problems that are common in people with diabetes. Many people benefit from specially designed diabetic shoes.

The problem

Over time, high blood sugar may cause poor circulation in the feet and reduce the ability to feel painful foot injuries (diabetic neuropathy). Wounds can go unnoticed, leading to dangerous infections. Complicating this, foot deformities may create pressure points, leading to blisters, ulcers, and other issues. Diabetic shoes provide extra cushioning, promote healthy circulation, and distribute pressure more evenly across the feet.

The right amount of cushioning—not too much or too little—makes all the difference. But how much is best for different people with different needs? Until now, there haven’t been any guidelines backed by scientific evidence. A study at Staffordshire University in the United Kingdom set out to change that.

Finding the answers

Researchers created a set of cushioning materials that varied in stiffness, then tested them on volunteers. No single degree of cushioning worked best for everyone. In the Annals of Biomedical Engineering, the researchers reported that people who weigh more or have a higher body mass index (BMI) needed stiffer cushioning than others. Getting it right brought significant improvements: the proper cushioning reduced foot pressure by 16 percent when subjects were standing and 19 percent when they were walking.

Do you need diabetic shoes?

Maybe not. Ask your doctor. If your diabetes is well controlled and your feet are healthy, you can probably wear ordinary shoes if they are comfortable, supportive, and you inspect your feet every day (as everyone with diabetes should do). Many diabetes experts recommend avoiding flip-flops, minimizing time in heels, and never going barefoot.

If you have numbness in your feet, foot sores, deformities such as hammertoes or bunions, or other foot troubles, ask your foot care provider about being fitted for diabetic shoes. Discuss how much cushioning might be best for your needs. Also, ask if you might instead add orthotic inserts such as footpads and insoles to conventional shoes you already own. In some cases, that’s enough.

Getting the right help

Different types of diabetic shoes are available for different needs. Therapeutic shoes help those with nerve damage or foot injuries. Orthopedic shoes ease pain in people with foot deformities. Both are prescribed by a doctor or foot care specialist, and they are often covered by Medicare and other insurance. You can order them online or at some pharmacies and specialty shoe stores.

Finding the right fit

Your foot care provider or an experienced shoe store clerk can give expert advice to help you choose shoes you’ll be happy with. Joslin Diabetes Center offers these tips for buying diabetic shoes:

  • Select shoes made of soft leather that can stretch.
  • Choose a cushioned sole for better shock absorption.
  • For good support, make sure the back of the shoe doesn’t collapse to one side.
  • Choose laced or Velcro shoes instead of loafers for better fit.
  • For proper toe room, the distance between your longest toe and the shoe tip should be half your thumb’s width.
  • Wear new shoes for only an hour or two the first day, then check your feet for injuries. Wear them an hour or two longer each day until you’re used to them.

A well-made pair of diabetic shoes may last a couple of years, but watch for signs of wear and replace them before they are too worn out to provide the support and comfort you need.

Do you wear diabetic shoes? We’d love to hear what you think of them. Add your comment below.