2018 Diabetic Foot Australia guidelines on footwear for people with diabetes

In January 2018 researchers from Australia, USA, The Netherlands and the UK published updated guidelines on footwear for individuals with diabetes. The ten recommendations were:

(1) to wear footwear that fits, protects and accommodates the shape of their feet.

(2) to always wear socks within their footwear, in order to reduce shear and friction.

(3) to wear appropriate footwear to prevent foot ulceration.

(4) for individuals at intermediate- or high-risk of foot ulceration to obtain footwear from an appropriately trained professional to ensure it fits, protects and accommodates the shape of their feet.

(5) for individuals at intermediate- or high-risk of foot ulceration to wear footwear at all times, both indoors and outdoors.

(6) for individuals at intermediate- or high-risk of foot ulceration (or their relatives and caregivers) to check their footwear, each time before wearing, to ensure that there are no foreign objects in, or penetrating, the footwear; and check their feet, each time their footwear is removed, to ensure there are no signs of abnormal pressure, trauma or ulceration.

(7) for individuals with a foot deformity or pre-ulcerative lesion, the healthcare professional should consider prescribing medical grade footwear, which may include custom-made in-shoe orthoses or insoles.

(8) for individuals with a healed plantar foot ulcer, the healthcare professional should prescribe medical grade footwear with custom-made in-shoe orthoses or insoles with a demonstrated plantar pressure relieving effect at high-risk areas.

(9) for any prescribed footwear to be reviewed every three months to ensure it still fits adequately, protects, and supports the foot.

(10) for individuals with a plantar diabetic foot ulcer, the healthcare professional should prescribe appropriate offloading devices to heal the ulcer.

van Netten JJ et al. Diabetic Foot Australia guideline on footwear for people with diabetes. J Foot Ankle Res. 2018 Jan 15;11:2.

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