Diabetes is a lifelong condition which can cause foot problems. Some of these problems can occur because the nerves and blood vessels supplying your feet are damaged. This can affect:
- the feeling in your feet (called ‘peripheral neuropathy’)
- the circulation in your feet (called ‘peripheral vascular disease’ or ‘ischaemia’).
These changes can be very gradual and you may not notice them. This is why it is important that every year you have your feet screened by a trained professional or assessed by a podiatrist. You can then agree on a treatment plan to suit your needs. This leaflet gives you advice about wearing the most appropriate footwear, taking into account the shape of your feet and your diabetes.
Unsuitable shoes or shoes that don't fit properly are the most common cause of foot problems in people with diabetes.
Check your feet every day
Check your feet every time you remove your shoes. Also remember to remove your socks, stockings or tights and check for any blisters, breaks in the skin, pain or signs of infection such as swelling, heat or redness.
Check your shoes
Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also, run your hand inside each shoe to check that no small objects such as small stones have fallen in.
The shape of your feet
Your feet can change shape over time. So when you buy new shoes, always check carefully that they fit you properly.
Buying new shoes
Get your feet measured
If possible have your feet measured and your new shoes fitted by a professional.
Make sure your shoes are long enough, deep enough and wide enough for your feet. If your shoes are too tight they will press on your toes.
Always try on both shoes
When buying new shoes, always try on both shoes. Most people's feet are slightly different sizes.
Buy your own shoes
If possible you should go to the shoe shop yourself and not ask somebody else to buy your shoes for you.
Wear new shoes around the house
Wear new shoes around the house for short periods (20 minutes) and then check your feet. Look for problems such as redness caused by rubbing or pressure. If this happens, you can usually return the shoes to the shop, but only if you have not worn them outside.
Advice on new shoes
If you are not sure if your new shoes are suitable, ask your podiatrist for advice before you wear them.
Types of shoe
A well-fitting shoe, boot or trainer with laces or a strap fastening will give your feet the best support. These fastenings will help to keep your foot firmly in place inside your footwear, which will help prevent rubbing. Avoid slip-on shoes and slippers as they give less support.
The heel should not be more than 3 cm (1¼ in) high.
Where possible the uppers (top part) of your shoes should be made from a natural material such as soft leather. Leather will fit to your foot without causing any rubbing and will help to prevent your feet from sweating.
Signs of wear and tear
Check your shoes for signs of wear, such as rough edges in seams or linings, and worn soles or heels. Always check your shoes are in good condition and replace them whenever there are signs of wear and tear that can't be repaired.
If you have been supplied with shoes, they will have been made to a prescription. You should follow the instructions your podiatrist or orthotist (the person who made your shoes) gives you. At first you should wear the shoes for short periods around the house, checking for any problems such as redness caused by rubbing or pressure. If this happens, you should contact your podiatrist or orthotist immediately.
When you and the person who prescribed your shoes are happy with the comfort and fit of the first pair, you will be supplied with a second pair. These should be the only shoes you wear.
Shoes will normally be prescribed with insoles. These are an important part of your footwear and you should only remove them if your podiatrist advises you to. It is important that you check the inside of your shoes every day to make sure no small objects have fallen in, and that no damage has occurred to the insole or lining.
If you notice any wear to the shoes, you should contact your orthotist or podiatrist.
Whoever provided your shoes will carry out all repairs or alterations to make sure that they match your prescription.
Socks, stockings and tights
You should change your socks, stockings or tights every day. They should not have bulky seams and the tops should not be elasticated. Some high-street shops sell suitable products – ask your podiatrist for details. All your socks, stockings and tights should be the right size for your feet.
Remember: if you are not sure about any shoes, socks, stockings or tights you are wearing, or new shoes you have bought, your podiatrist will be happy to advise you.