Table 2 Recommendations on footwear for people with diabetes

1

Advise people with diabetes to wear footwear that fits, protects and accommodates the shape of their feet

2

Advise people with diabetes to always wear socks within their footwear, in order to reduce shear and friction

3

Educate people with diabetes, their relatives and caregivers on the importance of wearing appropriate footwear to prevent foot ulceration

4

Instruct people with diabetes 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

Motivate people with diabetes at intermediate- or high-risk of foot ulceration to wear their footwear at all times, both indoors and outdoors

6

Motivate people with diabetes at intermediate- or high-risk of foot ulceration (or their relatives and caregivers) to check their:

a. footwear, each time before wearing, to ensure that there are no foreign objects in the footwear, or penetrating, the soles

b. feet, each time their footwear is removed, to ensure that there are no signs of abnormal pressure, trauma or ulceration

7

For people with a foot deformity or pre-ulcerative lesion, consider prescribing medical grade footwear, which may include custom-made in-shoe orthoses or insoles

8

For people with a healed plantar foot ulcer, prescribe medical grade footwear with custom-made in-shoe orthoses or insoles with a demonstrated plantar pressure reducing effect at the high-risk areas

9

Review prescribed footwear every three months to ensure it still fits, protects, and supports the foot

10

For people with a plantar diabetic foot ulcer, footwear is not specifically recommended for treatment; prescribe appropriate offloading devices to heal these ulcers