Ill fitting shoes the norm for diabetic patients

More than six out of ten people with diabetes are walking around in the wrong-sized shoes, exposing themselves to serious foot problems that could lead to amputation, according to researchers at the School of Medicine.

The study by researchers at the University's Diabetic Clinic at Ninewells Hospital and the Institute of Motion Analysis and Research (IMAR) involved examining and measuring the feet of 100 patients aged 24 to 89 at the clinic who had volunteered to take part.

Patients who were also attending specialist foot clinics were excluded, as were patients who had problems standing or were wearing specially provided footwear.

"All the patients had their feet fully examined and measured while t hey were both sitting and standing" explains co-author Dr Graham Leese, a consultant at the clinic.

Researchers found that 63 per cent of the patients were wearing the wrong-sized shoes. For example, 45 per cent were wearing the wrong width fitting, with the majority being too narrow.

"When people stand up their feet change shape as the arch of the foot flattens and the foot becomes wider and longer," explains Dr Leese. "Taking both these sets of measurements into account, only 37 per cent of the patients were actually wearing the right-sized shoes."

"Interestingly, patients who didn't have problems with lack of feeling in their feet - a common problem with diabetes - were just as likely to wear badly fitting shoes as those who did."

"We also discovered that almost a third of the patients said they took a different shoe size to the one they were actually wearing. This isn't helped by the fact that shoe sizes vary from make to make."

45 per cent of the volunteers had experienced previous problems with their feet, including ulcers, callouses, bunions, corns or swelling. Despite this, 22 per cent never checked their own feet and only 29 per cent checked them daily.

"Ill-fitting footwear is a regular feature seen in our clinics at IMAR when assessing patients; sometimes with up to 3 UK sizes smaller shoes than feet", adds co-author Professor Rami Abboud.

Foot problems could be reduced by adults being offered foot-measuring services in shoe shops, say the researchers. They would also like to see manufacturers developing standardised shoe sizes and expanding the range of length and width fittings that they offer, especially for patients who have no feeling in their feet.

Results of the study were published in the November issue of the International Journal of Clinical Practice.