More than six out of ten people with diabetes are walking around in the wrong-sized shoes, exposing themselves to serious foot problems that could lead to amputation, according to research in the November issue of IJCP, the International Journal of Clinical Practice.
Published to coincide with World Diabetes Day (14 November) the study, by the University of Dundee, has been welcomed by an expert in podiatry. She says that ulceration can have serious implications for patients and health services, including impaired quality of life, increased amputation risk and even elevated death rates.
The United Nations, which passed a landmark resolution in December 2006 recognising diabetes as a chronic, debilitating and costly disease, has designated World Diabetes Day as an official United Nations Day for the first time in 2007.
And the World Health Organization has said that the number of people suffering from diabetes could double to 366 million by 2030 and that 80 per cent of diabetic foot amputations could be prevented.
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.
Patients who were also attending specialist foot clinics were excluded, as were patients who had problems standing or were wearing specially provided footwear.
“All the patients had their feet fully examined and measured while they were both sitting and standing” explains co-author Dr Graham Leese, a consultant at the clinic, which forms part of University of Dundee.
The team found that 63 per cent of the patients were wearing the wrong-sized shoes. For example, 45 per cent were wearing the wrong width fitting, with the majority being too narrow.
“When people stand up their feet change shape as the arch of the foot flattens and the foot becomes wider and longer” explains Dr Leese. “Taking both these sets of measurements into account, only 37 per cent 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.”