John Nebitt M.D.
Footwear - Where to buy, when to buy and what to buy

Where to buy shoes:

  1. First ask your health care professional for their footwear supplier’s recommendations.
  2. If your health care professional cannot provide that information, try a reputable shoe store in your community. Tell the store clerk that you have diabetes. (If the clerk doesn't know why that matters, find a store with a clerk who does know.)
  3. A reputable shoe store will acknowledge the difficulty in fitting your feet and should offer to return your shoes if you are having problems with them as long as you have only had the shoes for a short period of time and have kept them clean by only walking with them on around your home.

When to buy shoes:

  1. New shoes should always be purchased in the afternoon and in advance of present footwear breaking down.
  2. You should always try on new footwear with the type of socks you usually wear.

Features of your new shoes:

You must never rely on "feel" when fitting shoes. It is very important that if pressure points develop (as indicated by redness of the skin over a bony area on your feet), the new shoes must be returned immediately.

The shoes should fit your feet and should be:

  • Closed toes and heels
  • Extra-depth, breathable leather uppers without a seam inside
  • At least ½ inch extra space at the end of your longest toe
  • Inside of shoe should be soft with no rough areas
  • Outer sole should be made of stiff material
  • Shoe should be at least as wide as your foot

If your feet require specially designed shoes, ask your insurance plan or HMO about coverage for the cost of the shoes. Medicare will cover foot exams and may cover special (orthotic) shoes and shoe inserts.

The following is a simple test to see if your shoes may be fitting correctly:

  • Shoe TestStand on a piece of paper (make sure you are standing and not sitting, because your foot changes shape when you stand)
  • Trace the outline of your foot
  • Trace the outline of your shoe
  • Compare the tracings: Is the shoe too narrow? Is you foot crammed into the shoe? The shoe should be at least ½ inch longer than your longest toe and as wide as your foot.



How to start using your new shoes:

Test-drive your new shoes.
When using a new shoe, slowly work up the time of their use from 30 to 60 minutes the first day with a slow build-up in the wearing schedule each of the subsequent days. This is important as leather shoes work in slowly.

Again, never rely on "the feel" of your shoes (especially of you have a loss of protective sensation in your feet). If you cannot see your feet properly to check for pressure areas after each trial wear period when trying out your new shoes, please ask a family member or a caregiver for their inspection assistance.

Keep your shoes or hard soled slippers next to your bedside and slip them on your feet as soon as you get out of bed. This will help you develop the habit of wearing footwear while walking around the house or outdoors which will serve to protect your feet at all times.

Do inspect the inside of your shoes for foreign objects every time before you put them on. A visual inspection plus shaking the shoe out before putting them on will help you detect tears in seams, cracks in the soles, pebbles, nails, or children's toys that will injure your feet.