Fit for purpose? Footwear for patients with and without diabetic peripheral neuropathy: A cross-sectional study

Published:August 27, 2020DOI:https://doi.org/10.1016/j.pcd.2020.08.009

      Highlights

      • The use of inappropriate footwear heightens local mechanical repetitive stresses on the foot in patients with DM.
      • Accurate measurement of foot and shoe length is necessary to ensure a correct fit.
      • Many diabetic patients do not wear correctly-fitting shoes, which increases their risk of foot ulcer.
      • Assessing footwear for fit, in primary health care and podiatry clinics, reduces the risk of foot injury.

      Abstract

      Aim

      This paper determines whether patients with and without Diabetic Peripheral Neuropathy use suitable footwear, taking into account that these persons are subject to a significant loss of sensitivity in the feet.

      Methods

      Cross-sectional observational study was conducted of 108 participants with diabetes mellitus. Inclusion criteria were at least five years’ progression of diabetes, the ability to walk unaided and no distal amputation of the foot. The presence of DPN was evaluated according to the criteria of the International Working Group on the Diabetic Foot. Foot length was measured using a Brannock® device and internal shoe length was determined using a CEGI® pedometer.

      Results

      In relation to adjustment, 21.6% of the shoes examined had no type of closure. The most common form of closure was laces, which were used in 32.4% of the shoes. 92.5% of footwear had internal seams. No significant relationship was found between the presence or otherwise of DPN and the use of appropriate shoe closure (p = 0.304), recommended heel height (p = 0.18), leather material (p = 0.77) and absence of internal seams (p = 0.759).

      Conclusions

      The majority of our participants living with DPN do not wear fitting shoes. Therefore, it is advisable to evaluate their use of footwear, both in primary health care and in podiatry clinics, to forestall potential complications.

      Keywords

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