Footwear for people with diabetes should achieve the following objectives:
Relieve areas of excessive pressure-
Any area where there is excessive pressure on the foot can lead to skin breakdown or ulcers. Footwear should help to relieve these high-pressure areas and therefore reduce the occurrence of related problems.
Reduce shock and shear-
A reduction in the overall amount of vertical pressure, or shock, on the bottom of the foot is desirable, as well as a reduction of horizontal movement of the foot within the shoe, or shear.
Accommodate, stabilize and support deformities-
Deformities resulting from conditions such as Charcot involvement, loss of fatty tissue, hammer toes and amputations must be accommodated. Many deformities need to be stabilized to relieve pain and avoid further destruction. In addition, some deformities may need to be controlled or supported to decrease progression of the deformity.
Limit motion of joints-
Limiting the motion of certain joints in the foot can often decrease inflammation, relieve pain, and result in a more stable and functional foot.
Proper footwear is an important part of an overall treatment program for people with diabetes, even for those in the earliest stages of the disease. If there is any evidence of neuropathy, or lack of sensation, wearing the right footwear is crucial. By working with a physician and a footwear professional, such as a certified pedorthist, many patients can prevent serious diabetic foot complications.