Best Shoes For Diabetes Without Neuropathy
What are the best shoes for people with diabetes? It depends. There are two broad categories of people who have diabetes, those with sensation, and those without. As diabetes progresses, the individual affected may lose sensation. This usually starts in the toes, but may progress to encompass the foot, lower leg, and beyond. This is called neuropathy, and these individuals need diabetic shoes and special inserts (More about neuropathy here). You need a prescription for diabetic shoes and inserts, see your podiatrist for further information.
This article describes best options for those people without neuropathy. I will be discussing athletic and walking shoes here, we will defer discussion of boots and dress shoes to another article. There are several elements that go into the best shoes; the support offered by the shoe, the fit, the material and the insert. A simple test of a shoe is to take it out of the box and bend it (folding the toes backwards). If the shoe folds over like a pancake, it’s poorly made and will provide little support. If, when folded, the shoe offers stiffer resistance it is better made and will offer better support.
What Is Shoe Fit?
Fit is critical when selecting appropriate shoegear. It is important to realize that the fit of every shoe is different. Even when comparing shoes from the same manufacturer and from the same line of shoes, the size will be slightly different. Lets picture a pair of women’s shoes size 8. Shoes are made using a device called a last. The last is used to determine the size of the shoe, but the last wears out over time. A given last may be used to make hundreds to thousands of pairs of shoes, but as it is used it is worn down. So the shoes that I referenced above which are women’s size 8 will have variation depending on whether they were manufactured early in the use of the last, or right before the last was retired. Also different manufacturers will have different lasts, and use different techniques to produce the shoes. The point I’m trying to make is even a pair of women’s size 8 shoes which are right next to each other on the shelf will have a slightly different fit.
What’s a Shoe Made Of?
Look at the material that the shoe is made out of. Most athletic shoes are hybrids made with mesh uppers, while walking shoes are either mesh or leather uppers. This is very important as the material will be right next to your skin. Mesh and leather both put tension against the skin, especially in the forefoot near your great toe and your little toe. These areas are called the first metatarsal and the fifth metatarsal.
If you have a bunion, or a tailor’s bunion, these bones will be more prominent, and will tend to ‘poke-out’ more. Over time both materials will adapt, but the mesh tends to hold more of it’s form, while the leather will be stretched into the shape of the underlying foot.
What Is A Shoe Insert?
The insert varies according to the shoe. The manufacturer places an insert of varying thickness which it believes will appeal to the most customers. These are standard inserts, not custom to a particular person. It has become more common to see memory foam inserts. Memory foam is made of viscoelastic which deforms when pressure is placed on it, but re-forms when the pressure is removed thereby assuming it’s prior form. Many individuals will benefit from more support offered by an over the counter insert (also called an orthotic). The most benefit will be derived from a truly custom insert, this is obtained from a podiatrist or orthotist/prosthetist. An over the counter orthotic can be purchased without a prescription, for a custom orthotic it is best to see a podiatrist who will either scan or take a mold of your feet. This guarantees the best possible fit.
If The Shoe Fits…
So when talking about the ‘fit’ of a shoe, we put all of the above together. The support given by the structural elements of the shoe, the elasticity of the upper portions, and the type of insert. If the fit is off the various pieces will actually work against you, and the shoes will hurt. How do you assess the fit of the shoes? First try them on, walk around a bit. Does anything hurt? Any new shoe will feel slightly strange, and a well made shoe will be quite firm in the beginning. After wearing the shoes for about an hour around the house, take them off. Then take your socks off and look at your feet.
Are there any spots that are red, are there any spots that are abnormally warm? The great thing about evaluating your feet is that most of us have two of them. So look at the other one, are there hot spots on both feet? Are there red spots on both feet? Do these areas hurt when you touch them? Are they sensitive. There really shouldn’t be any red spots, or if there are they should disappear within a few minutes. If there are red spots that hurt, the shoes are fitting improperly. If an improperly fit shoe is continually worn you will develop blisters near bony prominences, or areas where the shoe is rubbing the skin.
Get To Know Your Feet Diabetic Survivors!
As a Diabetic Survivor I want you to get used to examining your feet. Get to know your feet. They have carried you everywhere you have ever been. Take care of them and they will take care of you.
So Which Shoe Should I Buy?
To answer the question posed by the article, the best shoe for someone with diabetes is on that fits them well, is supportive and prevents injury. There are many excellent brands of shoes, and probably many poor quality manufacturers as well. I recommend New Balance shoes for athletic or walking shoes. They are well made, and they come in wide widths. The inserts that come in the shoes are usually removable, which allows for use of a custom orthotic if desired. In addition as I noted above there are many other excellent shoe brands, and New Balance may not be available in your area.
If you are unsure about the fit of new shoes, and you’ve read all the way through this guide, then find a local shoe store with a staff that will help you locate an appropriate shoe. Feel free to print out this article and show it to them. You may wish to share with them that you are diabetic, or if you have had any problems with your feet previously. You can also ask your local podiatrist, he or she will be happy to help!
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