Diabetic-friendly footwear should hold the foot securely without squeezing, rubbing or creating concentrated pressure.
If sensation is reduced, a shoe can cause damage without feeling obviously painful, so fit should be checked visually as well as by comfort.
How should the toe box fit?
There should be enough width and depth for the toes to sit naturally without being compressed by the upper. The toes should not repeatedly contact the end of the shoe during walking.
How should the heel fit?
The heel should sit securely without excessive lifting or rubbing. A shoe that is too loose can create friction even if the forefoot feels roomy.
How tight should the fastening be?
Laces or straps should hold the foot securely rather than being tightened as much as possible. Look for deep strap marks, pressure over prominent areas or changes in skin colour after wear.
What should you check inside the shoe?
| Check | Why |
|---|---|
| Loose objects | Stones or debris may cause injury without being noticed. |
| Folded or displaced insoles | Can create concentrated pressure. |
| Rough seams | May rub against the skin. |
| Damaged lining | Can expose hard or uneven surfaces. |
| Moisture | Persistent dampness can affect skin health. |
Does an insole change the fit?
Yes. Any insole or orthosis takes up space inside the shoe, so depth and width should be checked with the device in place.
Should you break shoes in?
New footwear should not require you to tolerate significant pressure or rubbing. If you have reduced sensation, introduce new footwear cautiously and check the skin afterwards.
Comfort alone is not enough if sensation is reduced. Always check the skin for redness, blisters or pressure marks after wearing new footwear.
When should a specialist assess footwear?
If you have neuropathy, significant deformity, previous ulceration, previous amputation or another moderate/high-risk feature, footwear may need assessment through a specialist foot service.
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