How Can I Make My Shoes Fit Correctly?
James Hanna, DPM, responds
Finding footwear that fits properly can be challenging for anyone, but it takes on a special importance when you have diabetes.
What to Know
Diabetes affects just about every part of the body—including your feet. If it goes undiagnosed for a while or is poorly managed over a long period of time, diabetes can cause a decrease in circulation and nerve function. That’s a problem because nerve damage (neuropathy) can lead to numbness in your feet, which can make it difficult to feel that a shoe doesn’t fit properly. Combine nerve damage with ill-fitting shoes, and you have the perfect storm for trouble: blisters and skin breakdown (ulcers) that can lead to infection. Poor circulation can slow the healing of ulcers and other wounds, which can up the risk for gangrene and even amputation.
Other factors, such as bunions, hammertoes, arthritis, and swelling, may also adversely affect how a shoe fits. People with these conditions may find that selecting a shoe or sneaker off the shelf leads to problems.
Find Out More
Be a smart shoe shopper. Take your time selecting the proper shoes, and be sure to ask about the return policy. Most retailers realize that trying on a pair of shoes for a few minutes in a store may not provide the full story. The shoe store will often let you purchase the shoes, wear them at home for a couple of hours, and then, if necessary, return them for an exchange (provided they were not worn outside or otherwise dirtied).
Any evidence of redness or irritation on the foot is a sign you need a different size or style. Keep in mind: Size isn’t everything. Different styles of shoes may offer a radical difference in fit, even if they are measured as the same size. Knowing your size gets you in the ballpark. Be prepared to go up or down a size depending on how that particular shoe or sneaker fits.
Consulting with a podiatrist for a comprehensive foot exam can help you determine whether there are special considerations to take into account. A visit to a pedorthist, an expert in creating shoes, orthotics, and other devices to reduce foot problems, may also be helpful.
Special types of shoes, such as those with extra depth (to provide room for hammertoes) or with an expandable upper portion (to accommodate increasing swelling throughout the day), may be recommended. Custom-molded shoes may be required for those with more significant deformities. Shoes with a special type of insole known as Plastazote can be helpful in reducing pressure in the areas that have previously gotten ulcers or have the potential to do so.
Diabetes is a complex issue that has the potential to create many foot and leg problems. Many of these can be avoided by keeping in mind a few simple rules regarding shoe selection and through consultation and follow-up with your health care providers.
James Hanna, DPM, is a fellow of the American College of Foot and Ankle Surgeons who has been in private practice in western New York for over 20 years. He serves on the board of trustees for the New York State Podiatric Medical Association.