Shoes that help prevent diabetic foot wounds should fit comfortably, protect the whole foot, and leave enough room for the toes without rubbing or slipping. A sturdy walking or athletic shoe may suit everyday use, but some people need extra-depth or custom-made shoes and pressure-relieving insoles. Wear socks, avoid going barefoot, check inside each shoe before putting it on, and inspect your feet daily.
Why are the right shoes important for people with diabetes?
Diabetes can damage the nerves in the feet, reducing the ability to feel pain, pressure, heat, or minor injuries. As a result, a shoe that rubs against the skin or a small object inside the shoe may cause damage without being noticed. Diabetes can also reduce blood flow to the feet, making wounds harder to heal. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), wearing protective shoes, checking them before use, and examining the feet regularly are important parts of foot care.
The goal is not simply to find a comfortable pair of shoes. Footwear should protect the skin, accommodate the shape of the feet, and reduce rubbing and excess pressure on vulnerable areas. The best choice depends on foot shape, sensation, circulation, and whether there have been previous wounds or other foot problems.
What features should shoes have to help prevent foot wounds?
For everyday use, look for shoes that protect the toes and soles while allowing the feet to fit naturally. A walking shoe or athletic shoe may be suitable when it fits properly and does not create pressure points. According to the Centers for Disease Control and Prevention (CDC), shoes should fit well, new pairs should be introduced gradually, and socks should always be worn with them.
Roomy toe box and sufficient depth
The toe box is the front part of the shoe that surrounds the toes. It should provide enough space for all toes to rest naturally without being squeezed together or pressed against the front. Adequate depth is also important, particularly if the toes bend or overlap, or if a bunion makes the foot wider. Shoes that are too narrow, too short, or too shallow can create repeated pressure and friction.
Smooth lining and secure fit
Choose shoes with a smooth inside lining and no rough areas that press against the skin. The shoe should hold the foot securely without pinching, squeezing, or slipping excessively as you walk. Adjustable laces or straps can help accommodate changes in foot shape and allow a more secure fit. Avoid shoes with pointed toes or high heels, which can put extra pressure on the toes.
Protective soles and suitable materials
A sturdy sole helps protect the bottom of the foot from sharp objects and other external injuries. Walking shoes and athletic shoes are often practical everyday options. Avoid thin-soled slippers, flip-flops, and footwear that leaves the foot exposed to injury. Shoes made from materials that allow ventilation may also be more comfortable for regular wear. However, no particular shoe material can guarantee that a foot wound will not develop.
How should you choose the correct shoe size and fit?
Shoe size alone does not determine whether footwear is safe. Two shoes marked with the same size may fit differently, and the shape of the shoe matters as much as its length. The International Working Group on the Diabetic Foot (IWGDF) recommends that footwear for people at risk of foot ulceration accommodate the shape of the feet and provide adequate length, width, and depth. People who have reduced sensation may not be able to judge pressure or poor fit reliably.
Use the following steps when shopping for shoes:
- Shop later in the day. Feet may be larger later in the day, so trying shoes on then can help you assess the fit under typical daily conditions.
- Try both shoes while standing. Make sure both feet have enough room and that the toes are not crowded.
- Wear your usual socks. Test the shoes with the socks you expect to wear regularly.
- Walk in the shoes before buying them. Check for slipping, pinching, pressure, or rubbing. The shoes should feel comfortable from the beginning rather than requiring a painful break-in period.
- Recheck your feet after wearing them. Look for redness, blisters, or other changes that could indicate friction or pressure.
If you have reduced feeling in your feet, do not rely only on how the shoes feel. A foot-care professional can assess the fit and help identify pressure points that you may not notice yourself.
Do you need special diabetic shoes or custom insoles?
Not everyone with diabetes needs prescription footwear. Many people can use appropriately fitted everyday shoes. Special therapeutic footwear may be needed when the feet have a shape change, pressure-sensitive areas, reduced protective sensation, or a history of wounds. These shoes are designed to accommodate the foot and may include extra depth, a modified sole, or room for a specially designed insole.
The American Diabetes Association (ADA), in its 2026 Standards of Care in Diabetes, recommends specialized therapeutic footwear for people with diabetes who have a high risk of ulceration. Relevant factors include loss of protective sensation, foot deformities, callus formation, poor circulation, previous ulcers, and a history of amputation. A healthcare professional can assess these factors and determine whether special shoes or inserts are appropriate.
When might extra-depth shoes be useful?
Extra-depth shoes provide more room inside the shoe to accommodate changes in foot shape or thicker insoles. They may be considered for people whose toe deformities or other pressure points make ordinary shoes unsuitable. Custom-made shoes, custom insoles, or toe supports may also be appropriate in selected cases. The choice should be based on a foot assessment rather than on the product label alone.
What if you have had a foot ulcer before?
A previous foot ulcer increases the importance of carefully selected footwear. If a wound on the sole has healed, the IWGDF recommends therapeutic footwear that has been shown to reduce pressure during walking to help prevent the wound from returning. The footwear may need to be designed around the location of the previous ulcer. Wearing prescribed footwear consistently, including indoors, is important for people for whom it has been recommended.
What socks should you wear with protective footwear?
Socks provide an additional layer between the skin and the shoe, helping reduce friction. Choose clean socks that fit without tight bands or bunching, with light padding and minimal seams. Seamless socks may be especially helpful when friction is a concern. Lighter-coloured socks can also make certain stains easier to notice if skin damage occurs.
Avoid socks that fold inside the shoe or create pressure around the toes. Put on fresh socks regularly and change them if they become damp. Even well-fitting socks cannot replace protective shoes, particularly when reduced sensation makes it harder to notice a sharp object or injury.
How can you prevent wounds when wearing shoes every day?
Choosing the right footwear is only one part of prevention. Make these habits part of your daily routine:
- Check inside every shoe before putting it on. Feel for pebbles, debris, sharp objects, rough lining, or anything else that could injure the skin.
- Wear protective footwear indoors and outdoors. Avoid walking barefoot, wearing only socks, or using thin-soled slippers. An unnoticed object on the floor can injure the foot.
- Introduce new shoes gradually. Begin with short periods of wear and examine your feet afterward. Increase the time only if the shoes are not causing skin changes or pressure.
- Inspect your feet every day. Check the soles, heels, sides, toes, and spaces between the toes. Use a mirror or ask someone to help if you cannot see all areas clearly.
- Pay attention to changes in fit. Swelling, changes in foot shape, or damage to the shoe lining may mean that your usual footwear no longer protects your feet properly.
The American Diabetes Association's foot-care guidance also advises checking shoes for sharp objects, wearing properly fitting footwear, and contacting a healthcare professional about wounds or other concerning changes. These habits are particularly important when foot sensation is reduced.
When should you seek professional advice about your shoes or feet?
Arrange a foot assessment if ordinary shoes repeatedly cause rubbing, if you have painful pressure points or persistent calluses, or if your toes or feet have changed shape. Reduced sensation, poor circulation, or a history of foot ulcers may also mean that routine footwear is not enough. A clinician or qualified foot-care professional can examine your feet, assess the fit of your shoes, and advise whether therapeutic footwear is needed.
Contact a healthcare professional promptly if you notice a new blister, cut, open sore, unexplained redness, warmth, swelling, or skin discolouration. Do not wait for a wound to become painful, as nerve damage may reduce the ability to feel it. A wound that is worsening or showing signs of infection needs urgent assessment. Do not attempt to treat a pressure-related wound simply by switching shoes without obtaining appropriate medical advice.
The most useful shoe is one that fits your feet and protects the areas most at risk. Regular foot checks, protective footwear, and professional assessment when needed can work together to help prevent diabetic foot wounds.