WHAT DIABETIC FOOTWEAR DO YOU NEED:
Shoes - Socks - Insoles?

Diabetic footwear: shoes, insoles and socks

The Diabetic Footwear market keeps expanding. Each yeat, new diabetic shoe companies come out promising they’ve found the perfect healing solution for your poor suffering feet. We diabetics very well know we are at risk of developing serious foot conditions. Undeniable. For that reason, we also know we have to take extra care of our feet. 

Does that mean we all need diabetic footwear? And if we do, what should we get: diabetic shoes, diabetic insoles, or diabetic socks?

Let’s find out!

1

PEOPLE WITH DIABETES
ARE MORE LIKELY TO HAVE
FOOT PROBLEMS

Most of diabetes-related foot problems arise from Diabetic Neuropathy and Peripheral Artery Disease, two severe diabetes complications. When high blood sugar levels have damaged your nerves over time, it can cause a decreased sensation from your legs and feet. This decreased sensation, along with a poor blood circulation, is responsible for most foot problems among people living with diabetes.

DIABETIC NEUROPATHY AND PERIPHERAL ARTERY DISEASE

The most frequent diabetes-related neuropathy is called Peripheral Neuropathy, and it generally affects the feet and the legs. Symptoms usually appear after several years of recurrent high blood sugar levels. They are many and they vary from mild to debilitating, and can sometimes be extremely painful:

  • Numbness
  • Reduced ability to feel pain or sensation in the feet
  • Reduced ability to feel temperature changes
  • Tingling
  • Burning sensation
  • Pain
  • Cramps
  • Increased sensitivity to touch
  • Loss of balance
  • Charcot’s joint or other joint issues

Another common diabetes complication that affects our feet is the Peripheral Artery Disease. It reduces blood flow in our body extremities which receive less oxygen than they need. This leads to healing difficulties and high risks of infections, ulcers, and gangrene.

  • Painful hips, thighs or calf muscles cramping
  • Leg numbness 
  • Leg weakness
  • Coldness in lower leg or foot
  • Unhealing wound on toes or feet
  • Leg’s color change (sometimes skin is shiny)
  • Loos of hair on feet and legs, and slower growth of toenails
  • No pulse or weak pulse in legs or feet
  • Sometimes erectile dysfunction in men

Both these lists of diabetic neuropathy and peripheral artery disease signs and symptoms are not exhaustive. Symptoms can vary from a person to another. The most important is you’re well aware that feet and legs can be severely affected by diabetic complications. So, always watch out for signs, and visit your doctor if you ever notice something different in your feet and legs. And remember you should examine your feet daily, and get a doctor foot examination at least once a year. Even if you do not have any particular foot problem! 

COMMON DIABETES-RELATED FOOT CONDITIONS

If you have diabetic neuropathy and/or peripheral artery disease, you are more likely to develop serious foot conditions. But even if you have not developed any diabetes complications yet, the mere fact that you have diabetes and high blood sugar levels puts you at high risk of developing and/or aggravating foot problems

These foot conditions vary from simple blisters to sometimes extremely serious foot and leg problems such as gangrene, and can even lead to lower limb amputation. According to the USA National Diabetes Statistics Report, 108 000 adults had lower extremity amputations related to diabetes in 2014. Almost all of these amputations originated from a common foot problem that has not been well taken care of. 

Here’s a list of the most common diabetes foot problems:

  • Ulcers
  • Feet swelling
  • Diabetic foot pain
  • Calluses
  • Corns
  • Dry feet
  • Infected blisters
  • Athlete’s foot
  • Fungal infections
  • Hammertoes
  • Bent toe
  • Bunions
  • Ingrown toenail infections
  • Gangrene

Here’s a much more detailed article on how to identify and avoid these most common diabetes foot problemsIn any case, when you have diabetes, foot care should be an essential part of your daily routine. 

DIABETIC FOOT CARE IS ESSENTIAL

It’s not because you have diabetes that you will have foot problems. First, if you properly manage your diabetes and keep your HbA1c below 7%, you are not at greater risk of developing nor aggravating foot conditions. 

Second, you can avoid most diabetes-related foot problems taking extra care of your feet:

If you follow these 5 essential rules you should stay away from most severe foot conditions. As clearly stated in our guidelines to diabetic foot care, quality footwear is a key element when it comes to diabetes foot care. Wearing well fitted shoes, good quality socks, and cushioning insoles does play a major role in avoiding foot problems.

But, does that mean you need to get specialised diabetic footwear? Not necessarily. It depends on your situation.

2

DO YOU NEED SPECIALISED
DIABETIC FOOTWEAR?

POOR QUALITY FOOTWEAR CAUSES FOOT PROBLEMS

Bad footwear can cost you a lot. Most of foot conditions that we’ve seen on the previous chapter are caused or aggravated by poor quality or poorly fitted shoes.

Shoes with friction or pressure point create calluses and corns. Hammertoes and bunions can be caused and aggravated by unfitted shoes. Ulcer, fungal and bacterial infections cannot heal if the shoe does not let your feet breathe. Ingrown toenails’ most common cause is pressure from the shoes. 

This does not necessarily mean all diabetic people should buy diabetic shoes. But it does mean that all of us must at least get some good quality well-fitted footwear. Easy to say, but how do we know if our shoes are good quality and well-fitted? 

Here are a few basic requirements you can rely on, along with the 10 points of proper shoe fit suggested by FootcareMd: 

  • There should be space for about the width of your finger between your longest toe and the tip of your shoe when you stand up.
  • Your shoes should not create any pressure or friction point on any part of your feet.
  • Your shoes fabric should let your feet breathe. Too much feet sweating is not good.
  • There should be a midsole (cushioning layer) inside your shoe to absorb shock and reduce impact.
  • Good quality shoes cost money. We're not talking luxury prices, but for less than $50 dollars there's no way you can expect proper quality footwear.

Now, if you have pre-existing foot conditions, or if you still do not feel good in properly fitted regular shoes, you should definitely look at diabetic footwear. It does make the difference in many cases. 

DIABETIC FOOTWEAR VS. REGULAR FOOTWEAR

Diabetic footwear is much more than some comfortable sneakers. It is professionally designed orthotic devices that specifically address diabetes-related foot conditions. Good diabetic footwear uses forefront technology to promote blood circulation, provide better motion and stability, reduce impacts on the foot, avoid any points of pressure, and limit sweating.

Shape, width, fabrics, deepness, posture… each factor is carefully studied to alleviate the specific foot conditions. Most sought-after features for diabetic shoes in comparison to regular shoes are extra-depth, deeper toe box, softer and more stretchable fabric, extra cushioning of the sole. If you have hammertoes, bunions, calluses, or feet swelling, I bet you already feel the difference!

SO, WHO DOES NEED DIABETIC FOOTWEAR?

Diabetic footwear is not for diabetic people. It is for diabetic problems. It is specially designed to address diabetes-related foot conditions and ease the pain they can cause. They are recognised as medical and therapeutical devices, and your medical insurance can even cover their cost.

So, first things first, if you do not have any foot problems, you do not need any specialised diabetic footwear. A good quality pair of shoes that you’re comfortable in and that do not create pressure points on your feet should be just fine. 

Diabetic footwear is particularly recommended in these 3 following cases:

  • You already have a foot condition such as ulcer, calluses, hammertoes, bunions, feet swelling, etc. Diabetic footwear can help you address these problems and ease the pain.
  • You do not have any specific foot condition BUT you have been diagnosed with diabetic neuropathy. Diabetic footwear can play a preventive role to avoid developing further foot conditions.
  • Your do not have any specific foot condition nor have you been diagnosed with diabetic neuropathy, BUT regular shoes are pressuring your feet and/or feel uncomfortable.

If you find yourself in one of these 3 situations, we highly recommend you investigate more into the diabetic footwear topic. Let’s see what kind of diabetic footwear would best address your problems.

3

DIABETIC SHOES
DIABETIC SOCKS
OR DIABETES INSOLES?

When one hears about diabetic footwear, one immediately thinks diabetic shoes. But diabetic footwear does not limit to shoes only. Sometimes, orthotic insoles or diabetic socks will just do the job for your feet, and at a much lower cost. They all address different foot problems.

DIABETIC SHOES Vs. DIABETIC INSOLES

We’re gonna be honest here. In 90% of the cases where you need diabetic footwear, we would recommend you get yourself some good quality diabetic shoes. They’re just the guarantee your current foot conditions are well taken care off and that new ones will not show up. 

Diabetic shoes take into account every little factor that can impact your feet’s comfort: shape, fabric, extra depth, deeper toe box, etc. Plus, they include diabetic insoles! They are usually quite expensive, but it is a worthy investment (especially if your medical insurance covers them!). You can find good quality diabetic shoes from certified orthotic shoe brands from prices starting around $80. You can even get yourself some custom molded diabetic shoes that will perfectly fit your feet, but it does come at a much higher price. 

Now, if your foot problem isn’t too serious, orthotic insoles for diabetes can sometimes do the job at a much lower cost. Insoles for diabetes, arthritis and sensitive feet are designed to alleviate pressure on the foot, reduce impact shock and minimise irritation. Prices range from $8 to approx $30, and here are a few tips on how to choose the diabetic insoles that best fit your feet 

Our opinion is that, if you’ve already started to have foot problems, you’ll end up buying diabetic shoes in the future anyway. But diabetic insoles can definitely help you in the meantime. One thing is sure though: better get good diabetic insoles than bad diabetic shoes

WHAT ABOUT DIABETIC SOCKS?

Diabetic socks are a totally different story. They are complementary to diabetic shoes and diabetic insoles, and address different foot conditions. 

They have two main jobs: keeping your feet dry and keeping your blood flowing. They do so thanks to technical features that regular socks don’t have, such as moisture-wicking materials, antimicrobial components, seamless fabric, extra padding, elastic-free binding, etc. They are specially recommended to people who experience bad blood circulation, excessive feet sweating, feet swelling, or any kind of fungal or bacterial infection

Just like for shoes and insoles, it is not because you have diabetes that you need diabetic socks. If you do not have any of the above problems and feel fine in your regular socks: keep them! As long as they do keep your feet dry. This is important. 

There are many different types of diabetes socks on the market. If you find it hard to choose the right ones for your feet, check out our Easy Table for diabetic socks features

4

BEFORE YOU BUY
DIABETIC FOOTWEAR

Now that things are clearer and you know what you need, here are a few more things to look at before you buy your new diabetic footwear. First, don’t forget to check if you can get coverage by medical insurance. Then, at the time of choosing, we strongly recommend you get top quality models from certified orthotic brands. They’re a bit more expensive, yes, but they are medically certified and guaranteed to be the best for your feet.

CAN YOU GET FREE DIABETIC SHOES?

It depends on your medical insurance. Wherever you live in the World, most private medical insurance companies provide diabetic footwear’s full or part coverage when it’s been medically prescribed. Call your insurer and check with the company what kind of coverage you’re entitled to and what paperwork you need to provide. 

USA - MEDICARE COVERS DIABETIC SHOES

If you live in the USA and are a Medicare beneficiary, this applies to you. In agreement with the 1993 Therapeutic Shoe Bill, Medicare Part B (Medical Insurance) provides reimbursement of therapeutic shoes and inserts for people who people who live with diabetes and meet qualifying requirements.  If you qualify, you can be covered for one pair of custom-molded shoes or one pair of extra-depth shoes per year + additional pairs one inserts. Click here to know if you qualify for Medicare coverage and what steps you need to take

GET TOP QUALITY FOOTWEAR FROM CERTIFIED ORTHOTIC BRANDS

There is no point in buying bad quality diabetic footwear. In that case, you’d be better off with regular shoes. If you’ve decided you need diabetic footwear, go for top quality and certified brands. For two reasons: 

– First, your insurance will probably only cover your diabetic footwear if it comes for a medically certified brand. 

– Second, your feet will thank you for that. Poor quality diabetic footwear can be counterproductive and do even more harm to your feet.

SO, WHAT ARE THE BEST DIABETIC FOOTWEAR BRANDS?

There are actually many certified orthotic shoe brands offering diabetic shoes and inserts models. In the US, Orthofeet or Apex are among the most established ones. 

Over time, we have specialised in reviewing specific categories of diabetic footwear. Find our best models suggestions here:

MORE ON DIABETIC FOOTWEAR

We hope this article has helped you out. Do not hesitate to leave your comments!
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