Like Cinderella’s Sisters, Many People With Diabetes Squeeze Big Feet Into Small Shoes

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A recent Scottish study of a hundred people with diabetes found that about 63percent of them were wearing the wrong shoe size. Because feet become wider andlonger when they are being stood upon, all the patients had their feet examinedwhile they were both sitting and standing.

Under those circumstances, only 37percent were wearing footwear of the right size. Forty-five percent of the shoeswere the wrong width, most often too narrow. Some people had settled for thewrong shoe width in order to get the right shoe length, and some may have boughta smaller shoe for the sake of vanity.

The right shoe size is important because ill-fitting shoes can cause foot ulcersthat eventually lead to amputation. The World Health Organization has said that80 percent of foot amputations could be prevented, in part by wearingwell-fitted shoes.

Unfortunately, 15 percent of people with diabetes develop afoot ulcer sometime in their lives. In this experimental group, 45 percent hadexperienced previous foot problems already, including ulcers, calluses, bunions,corns and swelling. Seven percent had foot ulcers, and 20 percent had sensorynerve problems in their feet. Nevertheless, 22 percent never checked theirfeet, and only 29 percent checked them daily.

Unfortunately, shoe sizes vary from one manufacturer to another, making itdifficult to know your size if you buy from different shoemakers. If you are inthe market for a new pair of shoes, find a store that uses those metalfoot-measuring devices that you might remember from shoe shopping as a child.In addition, purchase a pair that offers a choice of widths in each size.

What to Look for When Buying

According to the International Journal of Clinical Practice, the followingfactors should be considered when buying shoes:

"Ulcers can form because of tight-fitting shoes causing constant pressure.However, loose shoes also cause ulcers as a result of friction. When footwear isfitted properly, it can reduce high-pressure areas and hence reduce callusformation and the threat of ulcer formation. It will also fulfill its functionas a barrier to the environment. Ill-fitting footwear can disrupt thebiomechanics of the foot and ankle and can give rise to problems, includingpain. Footwear should be designed to relieve pressure areas and reduce shock andshear forces, and it should be able to accommodate deformities by supporting andstabilizing them."

"It is necessary that shoes fit for both size and shape. The shoe must be wide enough to accommodate the first metatarsophalangeal joint.Shoes should be fitted whilst weight bearing. The location of the widest part ofthe shoe should be checked, allowing extra room at the toe box. Adequate roomshould be left across the ball of the foot, and a snug fit should be made aroundthe heel. It is also important to realize that many people have mismatched footsizes."

Source: EurekAlert; International Journal of Clinical Practice, November 2007

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