A study conducted by the University of Dundee has been published to coincide with World Diabetes Day. A hundred patients aged 24 to 89 volunteered to take part in the shoe-size study carried out at a general diabetic clinic at Ninewells Hospital Medical School in Dundee, Scotland. People already attending specialist foot clinics were excluded, as were patients who had problems standing or were wearing specially provided footwear. The subjects had their feet examined both sitting and standing and measured using a 'Clarks' shoe shop device and foot width using a pair of callipers. Shoe dimensions were also assessed by recording the manufactured shoe length and using callipers to assess shoe width. A calibrated measuring stick standardised shoe lengths. Neurovascular status and the presence of deformities in the foot were also recorded. Sixty three (63)% of the group wore the wrong-sized shoes. The majority were considered too narrow for the foot and just less than half wore the wrong width fitting. Just over one third of the population wore shoes considered to fit their feet. No significance was found between any other variables, such as sensory neuropathy. Thirty percent of the sample group checked their feet daily but 22% of the registered diabetics never checked their feet despite less than half of the group reporting previous foot problems. The researchers conclude from this rather small survey more should be done to improve the foot-measuring services in shoe shops. They would also like to see manufacturers developing standardised shoe sizes (sic. fat chance) and expand the range of length and width fittings that they offer, especially for people no feeling in their feet. Somewhat surprisingly there are few published studies in medical literature which relate to measuring shoe size versus foot size in this high-risk population. A US survey previously assessed the prevalence of poorly fitting footwear in individuals with and without diabetic foot ulceration. Approximately one quarter of the subjects wore appropriately sized shoes but individuals with diabetic foot ulceration were five times more likely to have ill fitting shoes than those without a wound. The US researchers concluded poorly fitting shoes appeared more prevalent in people with diabetic foot wounds than in those without wounds with or without peripheral neuropathy. All authorities now accept the benefit of screening for shoe-foot mismatches to reduce the risk of lower-extremity ulceration is beneficial. However in the absence of shoe size standardisation what real advantage is there in knowing what shoe will fit, when that style may not be available or out with the means of the individual. It would take a revolution in the current shoe making industry to achieve this goal. Or so you might think?
Crocs Rx™, the medical division of Crocs, Inc., have recently been awarded the American Podiatric Medical Association (APMA)’s Seal of Acceptance for the entire Crocs Rx™ line. The award was based upon stringent podiatric standards and endorses the use of Crocs Rx™ line developed with input from footwear specialists, and includes shoes and socks designed for people with specific medical and therapeutic, podiatric conditions, many of which are associated with diabetes. Seems the ugly duckling shoe is the new order.