For some diabetics, extra thought and care need to be given to protect the foot’s skin. It can be damaged from pressure and shearing forces while inside a shoe. With many types of shoe inserts available it is hard to determine which type protects the skin and prevents shearing damage. Orthotics, store-bought arch supports, diabetic shoe inserts, and gel or foam shoe padding all fit inside shoe and are all designed to help the foot. But there are big differences in the inserts, not only in design and materials but also in function and purpose. These differences become very important when supporting a diabetic foot.
Buying an insert does not require a podiatrist, and many different options are available. A shoe pad is a thin layer of foam or gel meant to replace the sock liner or a shoe with something that gives more cushion. They offer little to no support, and simply make the shoe feel more cushioned. These give a diabetic no real benefit besides comfort. Store-bought arch supports come in a wide variety and price, ranging from flimsy arch pads purchased at a pharmacy to expensive hard plastic inserts sold at arch support chains. All of these are sized based on a shoe size and do not adjust for the shape and function of an individual’s own feet. These supports are excellent for people who need limited arch support or extra cushioning and provide a better level of support than shoe pad inserts. However, they still provide little benefit to diabetics as their support will not reduce foot pressure enough to protect against skin wounds and pressure points.
The next two types of inserts can be found at a podiatrist’s office. Prescription orthotics will actually alter foot structure. They are made from a hard plastic that conforms to the shape of the foot. They are commonly used in many individuals with and without diabetes to support excessive foot flattening, reduce arch pain, and treat excessive foot tendonitis. Orthotics manage the structural cause of foot wounds and are the preferred way of protecting the foot. Diabetic inserts are used to reduce pressure and shearing damage to diabetic feet. They are commonly used for diabetics with prominent bones, calluses, or a history of foot wounds. Both of these inserts require a podiatrist’s evaluation and fitting.