Shoes intended to reduce the risk of skin breakdown in diabetics
Many diabetic shoes have velcro closures for ease of application and removal.
Diabetic shoes (sometimes referred to as extra depth, therapeuticshoes or sugar shoes) are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with existing foot disease and relieve pressure to prevent diabetic foot ulcers.
People with diabetic neuropathy in their feet may have a false sense of security as to how much at risk their feet actually are.[1] An ulcer under the foot can develop in a couple of hours. The primary goal of therapeutic footwear is to prevent complications, which can include strain, ulcers, calluses, or even amputations for patients with diabetes and poor circulation.[2] Neuropathy can also change the shape of a person's feet, which limits the range of shoes that can be worn comfortably.[3] In addition to meeting strict guidelines, diabetic shoes must be prescribed by a physician and fit by a certified individual, such as an orthotist, podiatrist, therapeutic shoe fitter, or pedorthist. The shoes must also be equipped with a removable orthosis. Foot orthoses are devices such as shoe inserts, arch supports, or shoe fillers such as lifts, wedges and heels. The diabetic shoes and custom-molded inserts work together as a preventive system [4] to help diabetics avoid foot injuries and improve mobility.[5][6]
The evidence for special footwear to treat diabetic foot ulcers is poor[7] but their effectiveness for prevention is well-established.[8][9][10] Design features of footwear that are effective in reducing pressure are arch supports, cushioned cut-outs around points at risk of damage, and cushioning at the ball of the foot. Technology for measuring the pressure within the shoes is recommended during designing diabetic footwear.[11][12]
In the United States, diabetic shoes can be covered by Medicare.[13]
^Foot Complications Archived December 22, 2017, at the Wayback Machine, from the American Diabetes Association; first published no later than November 4, 2009 (as per archive.org); retrieved November 1, 2013.
^Diabetic Foot Care at ePodiatry; published 2003; retrieved September 6, 2011.
^DeMello M (September 10, 2009). Feet and Footwear: A Cultural Encyclopedia. Macmillan. pp. 92–94. ISBN 9780313357145.
^Chatzistergos PE, Gatt A, Formosa C, Farrugia K, Chockalingam N (June 2020). "Optimised cushioning in diabetic footwear can significantly enhance their capacity to reduce plantar pressure" (PDF). Gait & Posture. 79: 244–250. doi:10.1016/j.gaitpost.2020.05.009. PMID 32454304. S2CID 218911847.
^Healy A, Naemi R, Chockalingam N (July–August 2013). "The effectiveness of footwear as an intervention to prevent or to reduce biomechanical risk factors associated with diabetic foot ulceration: a systematic review". Journal of Diabetes and Its Complications. 27 (4): 391–400. doi:10.1016/j.jdiacomp.2013.03.001. PMID 23643441.
^Healy A, Naemi R, Chockalingam N (September 18, 2014). "The effectiveness of footwear and other removable off-loading devices in the treatment of diabetic foot ulcers: a systematic review". Current Diabetes Reviews. 10 (4): 215–230. doi:10.2174/1573399810666140918121438. PMID 25245020.
^Healy A, Naemi R, Chockalingam N (September 18, 2014). "The effectiveness of footwear and other removable off-loading devices in the treatment of diabetic foot ulcers: a systematic review". Current Diabetes Reviews. 10 (4): 215–230. doi:10.2174/1573399810666140918121438. PMID 25245020.
^Bus SA, van Deursen RW, Armstrong DG, Lewis JE, Caravaggi CF, Cavanagh PR (January 2016). "Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review". Diabetes/Metabolism Research and Reviews. 32 Suppl 1: 99–118. doi:10.1002/dmrr.2702. PMID 26342178. S2CID 24862853.
^Heuch L, Streak Gomersall J (July 2016). "Effectiveness of offloading methods in preventing primary diabetic foot ulcers in adults with diabetes: a systematic review". JBI Database of Systematic Reviews and Implementation Reports. 14 (7): 236–265. doi:10.11124/JBISRIR-2016-003013. PMID 27532798. S2CID 12012686.
^van Netten JJ, Raspovic A, Lavery LA, Monteiro-Soares M, Rasmussen A, Sacco IC, Bus SA (March 2020). "Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review" (PDF). Diabetes/Metabolism Research and Reviews. 36 Suppl 1 (S1): e3270. doi:10.1002/dmrr.3270. PMID 31957213. S2CID 210830578.
^Collings R, Freeman J, Latour JM, Paton J (January 2021). "Footwear and insole design features for offloading the diabetic at risk foot-A systematic review and meta-analyses". Endocrinology, Diabetes & Metabolism. 4 (1): e00132. doi:10.1002/edm2.132. PMC 7831212. PMID 33532602.
^"Bespoke shoes and insoles could prevent foot ulcers in people with diabetes". NIHR Evidence (Plain English summary). National Institute for Health and Care Research. August 5, 2020. doi:10.3310/alert_40657. S2CID 241787869.
^Therapeutic Shoes or Inserts, from medicare.gov. Accessed November 1, 2013.
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