Many people will trade their good foot health to get fashionable shoes like platforms and stilettos. For long periods of time, diabetic patients had to wear footwear that was both stylish and durable.
Crystal Holmes, DPM, and CWS is an assistant professor at University of Michigan's Department of Internal Medicine, Ann Arbor. She stated that there was only one type of diabetes shoes when she started her practice years ago.
Diabetic shoes have seen a significant improvement in the last few years. They are no longer considered unattractive or clunky. You can now find them in a variety of styles and with a rainbow of colors.
When it comes to shoes for diabetics, the tradeoff between fashionability & functionality is more difficult. Hillary Brenner, DPM, Tribeca Private Medical Group in New York City shared their tips on how to balance the patients' desire for fashion with clinical concerns.
Sources indicate that women are more attracted to style than men. The classic Mary Jane in diabetic footwear is an example of how aesthetics should be balanced with patients' lifestyles and pathology.
This style is generally favored by experts. Holmes said that this shoe style is loved by many patients for its versatility, both in professional and casual wear.
This design can add depth to your feet and make them look more attractive. This style can be used with orthoses if necessary. Mary Janes can be ordered in leather or cloth, and can be customized to fit foot deformities.
Holmes said that this style is not without its limitations. Patients with edema and bony prominences might not like the strap at the front.
Brenner dislikes the opening at the top of the shoe and insists that patients wear socks or stockings.
Holmes noted that the heel and toebox can be very wide, which can cause slippage.
Experts speaking with LER said that they first discuss the clinical goals for diabetic footwear with patients and then move on with lifestyle concerns.
Holmes said that he wouldn't recommend the same shoe for a 90-year-old diabetic patient who uses a community-ambulator to get around her house. He would rather not recommend it to a farmer aged 60 who still works on his farm every day.
It is safe to say that fashion will be more important to the 90-year-old than it is for the farmer.
Brenner said that shoes should be matched with activities. A three-hour meal may allow the patient to choose a more appealing, but less clinically-appropriate, diabetic shoe. Prescribed footwear is necessary for a full day of walking around a museum.
Brenner stated that "You don’t want to remove all options from patients."
It is important to offer options when negotiating with patients regarding fashion and fit. After receiving their diagnosis, many patients assume that they will have to wear diabetic shoes.
Brenner stated, "Just because someone is diabetic doesn't mean she'll need the shoe with the extra depth or rocker base." For a diabetic patient younger than 50 years old, the shoe may not be necessary. An older patient with balance problems will need a shoe that offers stability and support. There is no single shoe that works for all diabetics.
Holmes will compromise with a patient who insists on wearing a certain style. I tell them that you can wear the shoe for six months. During that time, we'll check your feet daily. She advised that you stop wearing the shoes she recommends if there are any irritations or problems.
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