Diabetes Forecast

If the Shoe Fits

By Tracey Neithercott ,

Anyone who's ever walked a mile in a pair of shoes that pinches and squeezes in all the wrong places understands the importance of fitting a shoe to your foot. Doing so can help you exercise more effectively-it's hard to pedal a half mile with leather chaffing your ankle-and prevent injuries like ingrown toenails, calluses, and blisters. For people with diabetes, proper foot care is essential since the disease slows wound healing and can turn minor scrapes into major problems. Even if you don't have diabetic neuropathy, which can prevent you from feeling a small pebble tumbling in your sock or a growing blister, it's important to be cautious. Adopt good habits now and enjoy healthier feet in the future. "These aren't things that are going to be happening to them now or next week," says Ben Pearl, DPM, ABPS, a podiatrist and sports medicine expert with a private practice in Arlington, Va. "We don't develop these problems overnight. It's one sand at a time if you think of an hourglass."

To prevent foot ulcerations as well as common aches and pains (think: bunions, hammertoes, and corns), find a shoe that fits your foot, whether you have high, normal, or low arches. Not sure which category you fall into? Wet your foot with water and step onto a paper bag; then match your footprint to one of the drawings at left/right. People who have flat feet—that is, too-low arches—tend to overpronate, or let their feet roll inward during motion. People with too-high arches put excess pressure on the outside of the foot.

If you're not one of the lucky few whose footprint matches the "normal" drawing, don't panic. Many shoe makers design shoes with high or low arches in mind. That's why it's important to head to a running store and get help from a professional. (A 2007 study found that 63 percent of people with diabetes wear the wrong size shoes.) Sure, your foot may not fit the most of-the-moment sneaker, but, says Pearl, "if you have a preconceived notion of a brand you're trying to get and that shoe doesn't match your foot, that can make a difference on how you perform." When trying on shoes, you should be able to fit a thumb's width above your big toe—no more or you'll experience too much friction. And always shop for shoes in the afternoon since your foot will be at its largest. "It's OK if your foot shrinks in the morning," says Pearl. "But if it's tight in the afternoon, that's a problem."

You can also correct with custom shoe inserts called orthotics. Though these custom inserts can cost big bucks, your insurance may cover them. If not, Pearl suggests investing in cheaper over-the-counter brands like Sole (www.yoursole.com). Just stay away from floppy types you can buy at the drugstore—they don't offer enough support to make a difference.

Before you hit the trails, make sure you're wearing the right socks, too. "I tell all of my diabetic clients to wear either Smart Wool or Cool Max [brand socks] that wick away moisture. Cotton is the worst. It absorbs water," says Pearl.



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