An Investigation into Footwear Materials Choices and Design for people Suffering with Diabetes

Use of appropriate footwear among diabetics and those with diabetic foot problems has been well documented to play a vital role in the prevention and treatment of established foot disease. The incidence and prevalence rates of diabetes in Africa are increasing and foot complications are rising parallel. Nigeria is Africa’s most populous nation which also has the highest number of people (up to 3 million) suffering with diabetes in the continent. This is related to the lifestyle of the people which is changing including diet. Many urbanites are embracing Western way of living. There is however lack of adequate knowledge about the role of footwear in the management of foot related problems among diabetic patients in the country. This study is the first of its kind to be done in Nigeria with an aim to develop a framework that would help to identify appropriate footwear materials and designs for people suffering with diabetes. To achieve this, data were collected through questionnaire and interview surveys, shoe upper materials analysis and foot measurements. In addition, Product Design Specification (PDS) and design framework were formulated. And functional footwear prototypes were designed, constructed and assessed. The data from the questionnaire survey indicate that up to 75% of the diabetic subjects have not received information about the type of footwear they should wear most often. The study revealed that the patients have very poor knowledge about diabetes and its complications, foot care, and the use of appropriate footwear. It was discovered that up to 53% female and 37% male of the patients were wearing slippers most often. Similarly, the findings from the medical doctors interviewed show that up to 66% of the patients were wearing slippers or slip-on (with no fastening mechanism) most often. The research revealed that financial constraint was a key factor to use of appropriate footwear by the patients. Many use cheap footwear regardless whether they provide the required protection and comfort to their feet or not. It was found out that specialist knowledge among medical doctors regarding foot care and provision of special footwear like orthopaedic and diabetic footwear to patients was very low. The shoe upper materials analyses demonstrated that leather has good physical properties required for making diabetic footwear. Data from the measurement of feet indicated that no individual’s feet are exactly the same even as people wearing the same shoe size might not have the same foot dimensions. It was concluded that these differences could have considerable effects on the shoe wearer. From the measured values, the tolerable allowance was found to be 3.4mm and 3.5mm for male and female subjects respectively. The fitting and comfort assessment of the prototypes have shown that some parts of the last used to make the prototypes would require amendments in order to accommodate minor foot deformities properly. The findings from the research were used to develop PDS and a research framework which could be used as a guide for diabetic footwear design and construction. Finally, the contributions of this research to knowledge and critical areas that would require further investigations were outlined