The Right Fit
It's so important for diabetics to wear properly fitted shoes to protect their diabetic feet. These patients are at risk of developing lower extremity complications, even ulcers that can lead to amputations in some cases. Diabetic shoes, combined with diabetic inserts help protect diabetic feet daily, both inside and outside. For best results, providers must strive for the best fit. Assessing current fit, measuring properly and being familiar with your vendor’s diabetic shoes can all play an important part in a best fit for your patients.
Remind your patients to wear the socks they normally wear with their diabetic shoes and for those who experience swelling, schedule appointments in the afternoon.
Assess the fit of your patient’s current shoes prior to measuring. This can be useful and help you determine a starting point especially if your Brannock measurement results in a larger discrepancy in foot length and arch length.
While your patient is standing, measure with your Brannock device. The Brannock measures length, width and arch length. Don’t forget the arch length! Arch length is where a foot flexes when a step is taken. If only measuring length and width, a patient can end up with shoes that fit, but experience foot irritation because the arch length had not been taken into consideration when ordering the shoes. If the arch length is a higher number than the length, a good starting point a size right in between. If the arch length a couple of sizes above length, start with a size closer to the arch length.
Finally, knowing your shoe brands and how they fit can help you guide your patients when choosing their shoes. Patients with deformities such as hammer toes and bunions would do well with shoes from brands such as Dr. Comfort or Orthofeet. All of their shoes have roomier toe boxes and are made specifically for diabetics. For your active patients who like Brooks brand, order at least a half or full size up, especially if the patient is getting custom inserts. Patients ordering boots and athletic shoes may want to order one width up as those types of shoes tend to be more snug. Patients with narrow heels should choose shoes with laces for more secure fit, and know your stretchable options so you can guide those patients who experience swelling or edema.
For specific questions or additional details about a specific brand or shoe, you can check out the brand website or contact your shoe vendor.