Shoe Basics: How to Find a Quality Pair of Shoes

What are diabetic shoes?

If you have diabetes, you are automatically at risk for developing foot issues because of poor blood circulation from high blood sugar. Those with diabetes are also at a higher risk of developing hammertoe, gangrene, corns, fungal infections, and bunions, among others. To prevent these conditions from occurring, wearing specially designed orthopedic shoes can help you reduce your risk and can help your feet stay healthy. Custom-made shoes may not always be necessary, but if you are experiencing deformities, they may be required for proper foot care. Each time you buy new shoes, get your feet measured in case anything has changed, such as development of hammertoe or bunion. Always consider potential changes in your feet when buying diabetic shoes.

When shopping for orthopedic shoes, make sure to avoid the following:

• Heels (wedges can be okay depending on your specific case)
• Shoes that do not fit
• Pointed-toe shoes
• Flat shoes, or shoes without designated arch support

Your podiatrist will be able to recommend shoe styles for you, in addition to local accommodating shoe stores. Usually, you won't be able to find appropriate orthopedic shoes in just any store.

The importance of diabetic foot care

Diabetic shoes and their importance has been underrated. First, I give my diabetic and non-diabetic patients the shoe basics. There are three simple areas of a shoe to check before you even try them on and check their fit.

You must check their support and quality of materials used. Most famous makers spend a lot of their money on advertising, the best shoe companies spend their money on the shoe materials (How many Nike ads have you seen? How many New Balance commercials have you seen lately?)

First, take two fingers and pinch the back heel counter of the shoe (this is just above the sole portion) and if the sides touch, the shoe fails in rearfoot support. Second, to test the middle of the shoe, bisect it in half longitudinally and twist it from one side of the line to the other. If there is obvious twisting, then the shoe fails in midfoot/arch support. Finally, to check the front of the shoe or toebox, bend the toe area to the laces. If it reaches, the shoe fails with forefoot support.

To drill down further for diabetic shoes, they should have perforations for air flow, should not have in inseam by the toe region, should have a higher and wider toebox to prevent toe friction/ulcers, should have thicker soles to absorb shock as diabetics can have neuropathy/poor feeling, should be extra-depth to accommodate for friction-reducing inserts, and should be made of a flexible material like leather, canvas, or suede.

The cost for diabetic shoes can approach $200 easily. Adding inserts can push the cost to $300-400. But the costs can be minimized, if not eliminated, with the Diabetic Therapeutic Shoe Program that some insurers like Medicare offer. The reason some insurers will pay for this is that it greatly reduces the cost of the potential for ulcers, infections, hospitalizations, and amputations.