13/11/2007

Wrong-Sized Shoes Pose Risk For Diabetics

More than six out of 10 diabetes sufferers are wearing the wrong-sized shoes, exposing them to potentially serious foot problems, which could lead to amputation, new research has revealed.

A study by the University of Dundee - published the day before World Diabetes Day in the International Journal of Clinical Practice(IJCP) - examined a hundred volunteers, aged between 24 and 89, who took part in a shoe-size study at a general diabetic clinic at Ninewells Hospital Medical School in Dundee.

All the patients were fully examined and measured while they were both sitting and standing. Researchers found that 63% of the patients were wearing the wrong-sized shoes, with 45% wearing the wrong width fitting, with the majority being too narrow.

Dr Graham Leese, a consultant at the clinic and co-author of the report, said: "When people stand up, their feet change shape as the arch of the foot flattens and the foot becomes wider and longer. Taking both these sets of measurements into account, only 37% 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."

The study found that 45% of the volunteers had experienced previous problems with their feet, including ulcers, callouses, bunions, corns or swelling. Despite this, 22% of those questioned never checked their own feet and only 29% checked them daily.

Researchers said that foot problems could be reduced by adults being offered foot-measuring services in shoe shops. They also said that manufacturers should develop standardised shoe sizes and expand the range of length and width fittings that they offer, especially for patients who have no feeling in their feet.

Podiatry expert Andrew Parnes from the University of Ulster agreed with the study. She said that ulceration could have serious implications for patients and health services, including impaired quality of life, increased amputation risk and even elevated death rates.

She also said that, given the scale of the problem, it would make commercial sense for manufacturers to work with health professionals to expand their existing ranges.

In her accompanying editorial in the IJCP, Ms Parnes called for greater research into the problem, pointing out that the study also raises concerns about patients with conditions like rheumatoid arthritis.

(KMcA)


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