Failure to perform recommended foot care and wearing inappropriate footwear can set diabetes patients up for foot ulcers. Ulcers are painful and potentially serious. They can sometimes lead to amputation.
Most diabetes patients polled for the study said they know proper foot care and properly fitting shoes are important. But they don't always follow through, according to Stephen Ogedengbe, MD, a researcher at the University of Benin Teaching Hospital in Benin City, Nigeria.
He presented the study at the American Association of Clinical Endocrinologists' meeting in San Diego.
''There is no such thing as perfect footwear for persons with diabetes mellitus," he tells WebMD. "However, there are shoes which can help prevent or delay the onset of foot ulceration in diabetes. There are also shoes which can cause or help accelerate the development of foot ulceration."
Survey on Diabetes Footwear
The study was conducted in Lagos, Nigeria. Ogedengbe and colleagues asked 41 patients with type 2 diabetes, on average about 57 years old, to answer questions about their footwear habits and foot care.
The researchers found some good news:
- 90% had education about footwear
- 83% wash and dry their feet, a practice recommended daily
- 51% do the recommended routine self-exams of their feet
However, about 56% told the researchers they always or occasionally walk around the house without shoes, which is not recommended. Nearly 15% did so outside, too.
Next, researchers evaluated the participants' shoes. They found 68% of the footwear to be inappropriate.
Among the shoes that didn't pass muster, Ogedengbe says, are:
- Shoes with pointed tips or toes
- High heels
- Thong-style sandals or flip-flops
Besides inappropriate shoe styles, he tells WebMD, some wore shoes that were the wrong size.
Despite these flaws in shoe wear, 73% of the patients thought their inappropriate footwear was acceptable.
Footwear Tips for Diabetes Patients
Here are Ogedengbe's tips for finding proper footwear.
- Avoid shoes with pointed toes.
- Don't buy shoes with too flat a sole or high heels because they don’t allow for even distribution of foot pressure.
- Look for styles that have soft insoles.
- Choose leather, canvas, or suede styles to allow adequate circulation of air. Don't buy plastic or other materials that don't allow the shoe to ''breathe."
- Look for such features as laces, buckles, or Velcro. These make it easier to adjust the shoe.
Second Opinion
''The study [result] doesn't surprise me," says David G. Armstrong, DPM, MD, PhD, professor of surgery and director of the Southern Arizona Limb Salvage Alliance at the University of Arizona College of Medicine, Tucson.
He reviewed the findings for WebMD but was not involved in the research. He serves on the scientific advisory board for Vasyli, a manufacturer of orthotics.
The study confirms what Armstrong observes with some patients, he tells WebMD. "The doctor and nurse can tell the patient something [about proper footwear]. Just because we tell them doesn’t mean they are going to be motivated to make changes."
What may help, he says, is to let those with diabetes know that the risk of foot ulcers is as high as 25%, according to the American Diabetes Association.
Wearing properly fitted shoes can help reduce that risk, Armstrong says. "The problem here is the neuropathy is silent," he says. With nerve damage in the feet, there is a loss of feeling in the feet.
Get an evaluation by a foot doctor every year, Armstrong says. "Doing that alone, just seeing the podiatrist, reduces your risk of getting a wound and then getting amputation by anywhere from 20% to 70%."
Proper shoes don't have to look like ''Frankenstein shoes," he says. He differs with Ogedengbe in that he does allow women with diabetes to wear heels, within reason.
Please call the Foot, Ankle & Lower Leg Center office in Las Vegas anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you. Please visit our website @ FallCenter.com or www.walkwithdiabetes.com. The Foot, Ankle & Lower Leg Center has Diagnostic imaging: Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.
Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures. In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries. This cutting edge technology enables patients to continue training with little or no down time. Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery. Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons. Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options). Dr. Ricciardi believes in quality service and puts his patients first!
