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Feature Article

Diabetes Foot Care Starts With Good Shoes

By Jennifer Sylvester, BSN, CDE

Who doesn’t have fond childhood memories of going barefoot all summer? For a person with diabetes, however, going barefoot or wearing poor fitting shoes is a very bad idea.

Injuries, calluses, blisters, bunions, hammertoes and other problematic foot conditions can form. In addition, diabetes can cause nerve damage, called diabetic neuropathy, which causes toes and feet to go numb. Imagine stepping on a tack and not even feeling it!   

Play Offense

People with diabetes are at higher risk for slow-healing wounds, infections and possible amputation. An injury or complication creates a skin opening and port of entry for bacteria to enter tissues. Infection can develop and potentially “outrun” the body’s immune defense causing soft tissue, muscle and bone damage. This is due to compromised circulation, another complication of diabetes.  

Controlling blood sugars and wearing proper-fitting shoes are the best lines of defense to save your toes and feet. Sturdy shoes may require an additional investment but keeping your feet healthy and injury-free are key to keeping all your toes and both feet.

Feet should be measured every year by a podiatrist or trained shoe salesperson since adult feet change over time and a larger shoe size becomes necessary. Regularly purchase comfortable shoes that will fit well and protect feet without causing blisters or pinching. Sturdy, supportive and wide, closed-toe shoes are the best choice. People with foot deformities or high ulcer risk may require custom shoes or orthotic inserts, but non-custom shoes with proper fit and support are generally adequate for most people with diabetes.

In addition to wearing proper fitting shoes, inspect your feet every day for blisters, sores, cuts, redness, bleeding or drainage, warm areas, swelling, ingrown toenails, and other abnormalities.

Always contact your primary care provider if any wounds or signs of infection appear. 

Shoe Buying Tips for Fit & Protection

  1. Always try on shoes before purchasing. They should fit properly before you leave the store and not require a “breaking in” period.
  2. There should be a 1/2 inch to 5/8 inch between the front of the shoes and the longest toe.
  3. Arch of the foot should be fully supported. Shoes should feel like they are restricting rolling movements without feeling tight.
  4. Check fit of the shoe at the widest and narrowest parts of your foot. Any bulges from the toes or bony prominences should not be visible, otherwise, choose a wider shoe.
  5. Shoes should slip slightly in the heel but not excessively or slide completely off the foot.
  6. Shoe shop later in the day when the feet are more swollen. Wear the socks that you will wear with the shoes.
  7. Wear new shoes for one to two hours for the first time, then check feet for cuts or blisters. The next day, wear them three to four hours and gradually build up time to make sure they aren’t injuring your feet. Replace shoes when they become worn, torn, or support starts to break down.

Did you know that you can receive foot care services at Samaritan’s diabetes clinics? If you need nail trimming, callus removal, or if you have questions about footwear or basic foot care, call your local diabetes team or visit

Read about three common foot problems and how to avoid them.