Sneakers, Sandals, Stilettos: How to Choose the Right Shoe While Living with Diabetes

My father was always a collector. He had volumes of stamps, drawers brimming with old receipts, and countless Ziplock bags of Box Tops that he’d eventually get around to donating. He also collected shoes. Golf shoes, sneakers, clogs, sandals, and loafers sat quietly in his closet, untouched for many years. He preferred to wear his black Nike sneakers on most days, the very same Nike sneakers that bore a sizable crater into his heel, a direct result of his diabetic peripheral neuropathy

People living with diabetes are at a heightened risk for developing diabetic peripheral neuropathy — excess sugar in the blood wreaks havoc on the nerves of the feet, eliminating protective sensation, or the ability to sense pain or discomfort. This leads to an increased risk for skin breakdown on the foot’s surface which can cause foot ulceration. My father did not feel the heel tab of his sneaker rubbing against his skin and in a matter of days, he had developed an ulcer that took over six weeks to heal. 

Shoes are part of our everyday lives and often reflect who we are as individuals. For those living with diabetes, it is important to choose footwear wisely to mitigate risk of developing foot ulcers. 

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Comfort Is Key

Think about a pair of shoes you tried on recently and didn’t purchase. Perhaps the material was too hard or the tongue rubbed against your skin. People living with diabetes need comfort; the common excuse “beauty is pain” should no longer guide your shoe purchases! Podiatrists recommend shoes that have a large “toe box,” which is the area in the front of the shoe where your toes sit side-by-side. Pointed shoes have narrower toe boxes that crowd toes, which can lead to blistering, calluses, corns, or worse… foot ulcers. It is also in your best interest to avoid high-heeled shoes, open-toe shoes, or sandals. Heels may exacerbate balance issues and shoes that are open to the elements can introduce small pebbles or other objects that can irritate the skin and cause problems

During your next visit at the podiatrist office, ask them what they’d recommend. If you see a shoe listed as “PDAC” approved, it means that a code has been assigned to it for the purposes of billing for Medicare. Take note—this is also something to chat with your podiatrist about! 

If the Shoe Doesn’t Fit… 

Proper sizing is very important for everyone, not just those living with diabetes. However, anyone with a diabetes diagnosis should take a trip to the shoe store and ask for a customer sales representative to help with sizing. Size nine shoes in your Sketchers may be too big in a different brand, so make sure to try on every pair of shoes you’re considering for purchase. Shoes that are too small will rub against the skin and introduce abrasions that can become inflamed and infected, while shoes that are too big will fail to provide the necessary support. 

Save your Soles

Your soles take on a lot: They sustain the weight you carry and in turn, need all of the support they can get. There are some materials that have gained a reputation in the diabetic orthotics and footwear space, such as PlastazoteⓇ  and ethylene vinyl acetate (EVA). Many shoe and shoe insert manufacturers are turning to PlastazoteⓇ or similar materials for its cushioning and pressure distribution along the entire sole’s surface; in other words, this material can help mitigate pressure points that can lead to skin breakdown and ulcer formation. EVA is another material used in shoe manufacturing for its innate flexibility and softness.  

After my dad’s foot ulcer healed, we threw out his old sneakers and spoke to his podiatrist about shoe wear that would be best for him. He found a pair of Sketchers sneakers that are perfect for him: soft, well-fitting, and breathable. People with diabetes are all different—how advanced your diabetes is a factor to consider with your podiatrist when discussing proper shoe wear. Wearing black stilettos or your battered Converse sneakers everyday isn’t a wise choice, but enjoying the occasional fancy feet isn’t out of the question either. Talk to a podiatrist—they can be your ultimate shoe guru! 

Written by Olivia Schreiber