Diabetes and your Feet
A diabetic has two major problem areas that need careful monitoring – their eyes and their feet.
If you know you are diabetic it does help your shoe fitter to inform them. Our members will always take the utmost care in fitting you, but will appreciate being told as they look carefully at the shoes you select and offer advice and product knowledge.
Diabetes can occasionally betray itself in leather footwear. A sufferer often perspires more and the salts in their perspiration can cause a white ‘bloom’ on a leather shoe (in the same way as walking in the snow and ice and letting shoes dry out.) However if you find your shoes have this bloom do not panic, it may simply be your shoes have got very wet at some point, or may indicate some other condition i.e. Bromidrosis (excessive sweating).
If you think you may be diabetic, or if you have any health concerns, your first port of call should be your G.P.
A Podiatrist will also be happy to discuss this condition and how it will affect your feet. Go to the Diabetes UK website as this is a mine of information and will point you to a local branch and offer best advice.
As diabetes affects the nerve endings it is difficult for diabetics to feel the onset of a foot problem. Because feet are more often out of sight and therefore out of mind, most Doctors and Podiatrists go to great lengths to warn of foot health problems associated with diabetes, as they can be prone to ulcers, and in extreme cases gangrene can be an added complication.
Temperature really matters whether it is the weather or your bath water. Extremes of temperature are difficult to judge for a diabetc.
FOOTWEAR TIPS FOR DIABETICS:
Shoes should fit comfortably with room for toes to move and a snug fit at the heel cup. They should not be too tight or too loose. A snug (not tight) fit is vital for the shoe to stay properly positioned on the foot giving shoes less chance to slip and rub.
Check inside new shoes to ensure there is nothing sharp or rough i.e. seams or stitching, that can rub or break the skin, and that any packing material/foreign object has been removed.
Soft leather is by far the best upper material. It will mould to the foot and as it is a natural fabric it will breathe, allowing perspiration to expire naturally.
Alter heel heights and types of footwear worn. This is quite important for everyone, diabetic or not. It exercises the arches and tendons in the feet and tendons and muscles in the legs to. It also helps with your eye/foot co-ordination.
Ladies like their heels. Try to have several pairs of shoes of differing heel height, change them daily, and allow them dry out naturally in-between wear.
Avoid very pointed toe shapes – although a Qualified Shoe Fitter could probably fit you correctly with a pointed toe shape which will no doubt bear no resemblance to your ‘normal’ shoe size, but they will take several factors into account and pad accordingly. It is risky to buy pointy- toed shoes that are self-fitted as you are more likely to buy them too tight.
Trainers are designed for sportswear. Some people wear them as every day shoes. As they are full of synthetic padding, they need to dry out gently and keep aired as they can harbor fungal infections. Remember that a mushroom is a fungus and they grow in dark, warm, damp conditions…the inside of a shoe – particularly a well padded one!
High heels should only be worn for brief occasions and if possible avoided. Your feet take your entire body weight through them, so when wearing high heels instead of the weight and strain going through your heel and centre of gravity in the normal way, it is shifted forward from the heel to the toe/ball of foot area. If a court shoe with covered vamp (front) is worn, the toes will be pushed further forward and can rub in the toe box area – so a good half insock might be needed to hold the foot back in the heel cup BUT this can also mean that the insole takes up some of the volume so that toes rub on the vamp of the shoe…again not good. A peep toe high heel may allow toes a little extra space BUT where the leather is cut around the toes may also restrict them or create pressure, so make sure your toes are not poking through but sitting comfortably. Fashion does not have to be boring or painful, you just need to be sensible and wear the right shoe for the right occasion – THAT FITS PROPERLY! Heels are nice when worn in moderation, but do avoid sky-scraper stiletto’s! If you feel a pressure point then you know it is likely to be the area the shoe will rub. Be sensible, your health is more important.
Try to choose a style with an adjustable strap. Fashion is always of paramount importance to many people, not just the young and often bars and straps, hook & loop or lace fastenings simply don’t cut it, they are not ‘the look of the day’, but in terms of helping your feet, an adjustment should be a major consideration. A diabetic foot seems to have a mind of it’s own and will vary in size and shape during the day according to temperature (although to be fair this happens with most feet but we simply take it for granted, or take our shoes off). A diabetic cannot take pain for granted, it must be acted upon immediately. If you have to wear the same pair of shoes all day and don’t get the opportunity to change them, then give your feet some thought, if you are conscious of pressure from your shoes let out the adjustment a little to give a bit more room – but don’t forget to do the reverse if you feet cool down!
Slippers are nice to wear indoors in the colder weather and for those who rarely go out. However quality is vital as cheap slippers have very little construction strength and quickly become trodden down and misshapen. They are likely to slip about on the feet and can be dangerous (just ask A&E). Dependent on age group, house shoes might be better – or simply slipper socks or bare feet if it is a safe, clean, warm environment.
Flip Flops were very fashionable, cheap and easily accessible but for diabetics need great consideration. The toe post can rub – particularly if worn on the beach or a gritty environment. Occasionally the feet will slip/twist from the sole unit and can be cut on the pavement/ground and cause infection. The soles can be penetrated quite easily, so a sharp stone, nail etc. could penetrate the sole of your foot. Probably best to keep this footwear solely for the beach or swimming pool.
Boots are difficult to fit – even for a professional shoe fitter, as it is not as easy to see where the outer of the footwear is touching the foot. Follow the rules for shoe fitting and make sure they don’t slip up and down at the heel and room to wiggle toes. You will probably wear thicker socks in colder weather, so bear that in mind and wear the thickness of sock you intend to wear with them when fitting/buying them. The thickness of a sock can make a big difference to the width fitting.
Monitor sock drawers regularly and discard old, outgrown or misshapen socks. Socks are not expensive to replace, but it is too easy to underestimate their effect on your feet.
The most normal outfit for a baby is a ‘baby-grow’ / all-in-one as beautifully illustrated by these gorgeous babes in their lovely outfits. They may fit in the body for ages, but often the baby’s feet have outgrown the foot end or legs are too long for them. We would normally say cut out the foot section to make them last longer for a baby without diabetes, but it is safer to buy a larger baby-grow for a diabetic infant.
Socks should be made of cotton or natural fibres rather than stretch socks which are nylon. Why? Because nylon socks are more likely to shrink in the wash. Buy the right size as too small are restrictive, but too big means you have a ‘wodge’ of spare material inside your footwear which will fold and rub.
The toes in most socks are stitched in using nylon thread which can become brittle and sharp – which can rub toes. There is often a ‘casting off’ knot at the end of the toe seam and that can rub too.
There are special ‘all in one’ socks for diabetics and your Podiatrist may know a local supplier, if not they are available online.
Make sure that woollen socks stay in shape and that threads do not come loose, or they may twist around toes and restrict circulation.
Clean feet and clean hosiery every day are vital. Dry your feet carefully – particularly between the toes.
Check water temperature before putting your feet in the bath…if too hot a scald will take time to heal and will need medical attention.
If you notice a red patch or blister on your feet don’t panic, but do see your GP or Podiatrists a.s.a.p.
A little drop of salt in some cool water will cleanse and cool your feet and any abrasion.
Trim toe nails regularly and carefully – no sharp corners.
If you can afford a weekly visit to the Podiatrist/Chiropodist, this is recommended.
Do not dwell on worries however small they may seem, check them out, but remember – prevention is better than a cure!.