Diabetics risk foot ulcers from ill-fitting shoes

Last Updated: 2007-11-19 10:30:17 -0400 (Reuters Health)

NEW YORK (Reuters Health) - New research from the UK suggests that most people with diabetes are wearing shoes that don't fit correctly, putting them at risk of foot ulcers, which can ultimately lead to amputation.

"We do know from other studies that about 80 percent of all amputations start with a foot ulcer, and that's why it's important to try to prevent these foot ulcers in the first place," Dr. Graham P. Leese of the University of Dundee in Scotland, the study's lead author, told Reuters Health.

Leese and his colleagues measured the foot length and width of 100 people attending a diabetes clinic. Only one-third of them had at least one correctly fitting shoe. Only 24 percent had shoes that were wide and long enough for both feet, measured while they were sitting, while 20 percent had shoes that fitted properly while they were standing.

Both too-tight and too-loose shoes can rub against the foot, which is a problem for the 15 percent to 20 percent of diabetic individuals who have lost sensation in their feet, Leese noted.

"For the majority of people it probably isn't hugely significant, because if their sensation is normal they will feel shoes rubbing and do something about it," he said. "Its relevance is for patients with numb feet."

These patients should check their feet daily, and seek help as quickly as they can if they see any signs of rubbing or ulceration, he added. They should also check to make sure their shoes are fitting them right in both length and width; patients in the study were particularly likely to be wearing shoes that were too narrow.

People's feet often change shape and get broader as they age, Leese noted, but many may still buy shoes in their old size and width.

SOURCE: International Journal of Clinical Practice, November 2007.