Diabetic Shoe Upper Pressures: Preliminary Approach to Identify Relative Levels of Comfort and Injury

ESBiomech 2021Diabetic foot is one of the most serious complications affecting the feet of diabetic patients. It is characterized by a progressive loss of protective skin sensitivity and requires an early diagnosis due to the imminent possibility of infection, ulceration, and amputation [1]. Frequently, the anatomical deformation of the foot and the use of misfit shoes compromise the biomechanics of the foot, causing abnormal overload and minor trauma that can precipitate ulceration. The most critical pressure points, located in the plantar and dorsal region of the foot, are already well identified. In this sense, in addition to increased clinical attention, the use of appropriate footwear is also an essential factor in preventing injuries. The shoe must have an internal length between 1 and 2 cm greater than the foot, it must be adapted to the widest part of the foot and the height of the toecap must guarantee sufficient space for the toes. The choice of shoes should be evaluated with the patient standing and preferably at the end of the day when the feet are more likely to be swollen. In more complex cases, the use of custom-made shoes should be advised