The diagnosis of “diabetes” sends shivers thru most people. While definitely not a death sentence as it has been in the past, the word conjures up the images of needles, tasteless food, the possibility of dialysis and blindness. While this blog won’t attempt to delve into the finer points of the disease, it will focus on just one aspect that will make life easier and attempt to make you aware how to make your diabetes a bit “easier on your feet”.
A common side effect of diabetes is a phenomenon called “diabetic neuropathy”. This is a disease entity that causes your feet to lose the normal sensation of pressure, pain and proprioception. While this might not seem like a big deal compared to other aspects of the disease, if left unchecked, it can lead to infection, amputation and even death.
In addition to checking your feet every day and keeping them clean, warm and dry, diabetic shoes are a simple thing to help extend the life of your neuropathic feet.
The shoes themselves are composed and function in several ways to accomplish this.
First and foremost. If you believe your feet to be neuropathic, you need to visit a or certified Pedorthist to make sure the shape of the shoes fit the shape of your feet. Easily said but not easily done by most people. The diabetic shoes help to accomplish this in several ways.
1) The shape : This is easily done as the shoes have a wider , and higher toe box to make sure that the toes are not being rubbed into the front or top of the shoes. This prevents the formation of blisters and callouses , that in a diabetic can and will lead to disaster. The soles are also a bit more substantial to allow better wear and more shock absorption, as well as a firmer ”footprint “ of the shoe as it contacts the ground.
2) The insoles: These are composed of several special material that cushion, comfort and cradle the foot so that with each step, the foot does not rub against the inside of the shoe. These materials are often “heat sensitive” and form impressions of things such as depressed metatarsals and help to distribute the weight of the foot in a more even pattern as the foot goes thru the gait cycle. Your foot specialist will frequently check these insoles to make sure they are wearing properly, and change them several times a year.
3) Fastening system or “Laces vs. Velcro straps”: If you can’t feel pressure on your feet how is one to know if they are laced too tightly?? Diabetic shoes usually have either one or two wide straps with which the use of Velcro not only make the shoes easy to lace, but help to make sure they are not too tight on the top of the feet. Let’s not forget that neuropathy can also affect the hand as well as the feet. If you can’t feel your fingers, how would one be able to tie shoe laces. This fastening system is also a tremendous boon for the millions of people with moderate to severe arthritis).
To sum up… The triad of daily foot inspection, proper sock s and use of diabetic shoes will go miles in helping to keep your feet ready to take that next big step toward tomorrow, as you deal with the daily struggle against diabetes.
Blog submitted by Rob Kosofsky DPM.