Diabetes is one of the most prevalent diseases of our time and is affecting more and more Canadians each year. It is a disease where the body is unable to produce insulin, or the body does not produce enough or cannot effectively utilize the insulin that is produced. As a result, some people living with diabetes may experience reduced circulation or sensation in their feet and may not be able to feel if something in the shoe is irritating the foot. If the foot is irritated by the shoe, it can result in a wound or ulcer which can be dangerous and could ultimately result in hospitalization or amputation. Lower limb or foot complications resulting from diabetes may be prevented through daily footcare and proper shoe selection.
The Canadian Diabetes Association (www.diabetes.ca) recommends that all people living with diabetes should be instructed on proper footcare and have foot examinations at least once a year to avoid the risk of developing foot problems. Qualified healthcare professionals, including Canadian Certified Pedorthists, can assess structural abnormalities, signs of neuropathy (loss of nerve function) and vascular disease, and evidence of any ulcerations and can perform foot examinations on those living with diabetes.
Along with regular foot examinations, a daily footcare routine is equally vital to help maintain the health of the feet and protect against foot problems that could lead to amputation.
Daily Footcare Tips:
- Do a visual foot inspection to check for redness, broken skin, sores and bleeding. See your doctor immediately of any of these problems arise.
- Wear proper fitting shoes around the house and outdoors to protect feet from injury.
- Wash feet with soap and warm water everyday, but do not soak them.
- Avoid heat pads or hot water bottles, even though your feet night get cold easily. With lack of sensation it is easy to burn the feet if the water is too hot.
- Avoid socks with heavy seams, as they can cause irritation of the skin and lead to breakdown or ulceration.
- Do not wear tight, constrictive socks or clothing that can limit blood flow to the extremities.
Shoe Fitting Tips:
- Have shoes fitted by an orthotic and footwear expert such as a Pedorthist.
- Look for soft uppers with minimal seams, firm cushioned soles, removable insoles, a strong heel counter and a rockered sole ( to help remove pressure under the heel or front of the foot).
- Avoid restrictive footwear, such as high heels, pointed toes or shoes that are too narrow.
- When buying a new show it is good practice to remove the insole and stand on it to see if the foot overlaps the insole, indicating the shoe is too narrow or short for the foot.
- There should be a full finger width between the end of the longest toe and the end of the shoe.
- Avoid seams over the toe area of the shoes.
- If there is a problem with lower limb swelling, graduated compression stockings can help control swelling and maintain the fit of shoes over the course of a day.
Shoe selection is vital to those living with the disease. Pedorthists are trained to trouble shoot shoe fit issues for people with diabetes and help to reduce the risk of amputation by assessing structural features of the foot. Additionally, through custom-made foot orthotics and shoe modifications, pedorthists help alleviate the effects of lower limb and foot abnormalities to help prevent foot problems before they begin.
*Source: Pedorthic Association of Canada, Diabetes and Footcare brochure, 2009