Diabetic Shoewear

Scheck & Siress

Orthotics and Prosthetics, Inc.

Submitted by Jeff Linton, C.P.O. and J. Peter Oakes, C.P.

Shoewear for people with diabetes is very important. As the normal protective sensation of the lower extremities becomes impaired by the diabetes. proper shoewear becomes even more critical. Shoes serve to protect and balance the feet and distribute pressures evenly throughout the foot or transfer pressure away from involved areas.

One of the simplest, most significant factors in evaluating proper shoe fit is that the shoe should conform to the shape of the foot. The footwear needs of many diabetic patients can be adequately addressed by utilizing the wide variety of ready-made shoe sizes and widths presently available from orthopedic shoe manufacturers.

The characteristics of a proper shoe are as follows:

  1. Pliant leather
  2. Blucher type lace closure to accommodate foot size changes
  3. Roominess
    • Extra Depth
    • Wide and high toe box
    • Accomodates a soft insert
  4. Contour last - blunt, rounded toe box
  5. Sewn welt
    • Increases M-L Stability of shoe
  6. Shock absorbing sole
    • Crepe
    • Vibran
  7. Wedge heel vs. Standard heel
    • A wedge heel is continuous with the sole. ie., there is no space between the heel and sole as there is with a standard heel.
    • Prevents downward displacement/collapse of the shoe at the anterior border of a standard heel which generally corresponds to the mid-foot.
  8. Soft insole or molded insert
  9. Rocker sole
  10. Proper sizing
    • There should be 1/2 inch additional space beyond the ends of the toes to accommodate the anterior drift of the foot when ambulating,

There are instances when a patient's feet cannot be accommodated adequately by a ready-made shoe so a custom made shoe would be indicated. Some indications for a custom made shoe may be :

  1. Severe foot deformities, such as: talipes equinovarus, equlnovalqus, calcaneovarus, etc.
  2. Marked leg length discrepancy
  3. Marked foot size discrepancy
  4. Congenital absences or amputation at various levels of the foot
  5. Foot with impaired circulation
  6. Severely arthritic foot

The main advantage of a custom-made shoe is that it conforms to the foot's unique shape and will provide optimal support and comfort that could not have been achieved with a readymade shoe. The main disadvantages of a customade shoe are:

  1. Cost- a pair of custom shoes averages $550.00 - $600.00. This compares to an average cost of $150.00 -$200.00 a pair for ready-made orthopedic shoes.
  2. Cosmetic appearance - they are not considered stylish or attractive.


Medicare will reimburse eighty percent of the Medicare approved amount for shoes only if the patient has a diabetic foot.

Scheck & Siress
1145 Madison Street
Oak Park, IL 60302
(708) 383-2297