If you have diabetic peripheral neuropathy, you'll need to select shoes and break them in carefully to help prevent any type of injury. Even a tiny blister or ulcer can rapidly escalate into infection and gangrene, which could lead to an amputation.
"If you're buying a pair of shoes, you should noteven if it's a Hush Puppyyou should not wear the shoe a full day," says Deborah Cochrane, 57, who has type 2 diabetes and lives in New York City. "You should phase it in. Wear it two hours and take it off. Because the shoe is basically fighting against your foot and if you develop a little blister, you're out for the count."
It's also important to avoid going barefoot or wearing any shoes that don't protect your feet from injury.
"Reckless behavior when you have neuropathy is walking around in flip-flops or barefoot," says Joseph LeMaster, MD, MPH, of the University of Missouri-Columbia.
Shoes are required, even on the beach. "If you're on vacation in the Caribbean, can you imagine stepping on a shell? That can ruin your whole vacation," says Cochrane. "You have to be very, very careful of infection."
Here's what you should look for when choosing shoes, according to the National Diabetes Education Program.
- Select lighter shoes over darker ones. Just 30 minutes in the sun can increase foot temperature 7.8° to 13.6° more in black shoes than white ones.
- Get prescription footwear. Although Medicare and other insurance companies cover custom-made shoes and inserts, less than 1% of people who could get them, actually do get them. Your doctor writes a prescription and an orthopedic surgeon, orthotist, podiatrist, or pedorthist can fit them for you.
- Select off-the-shelf comfort shoes or sneakers that are long enough, have room for your insert, and have laces or Velcro so that you can adjust them if you have foot swelling.
- Use off-the-shelf insoles in combination with well-fitted shoes to relieve pressure on the foot, if your doctor feels this will be adequate to prevent foot injury.