The Role of Footwear in the Prevention of Diabetic Foot Problems

The role of footwear is to protect the foot from unsafe environmental conditions and to improve walking and running performance. Diabetic patients with long-term complications, such as peripheral neuropathy, which deeply modify foot structure, foot function, and the resulting gait, may develop unnaturally concentrate peak pressures under small areas at the heel, forefoot, and hallux. Because of this dangerous condition, such patients, without proper protection, are vulnerable and at risk of foot ulceration. Unsuitable footwear may be responsible for the appearance or the recurrence of a foot ulcer. Recent research has helped to better understand the criteria which should be taken in mind when prescribing or making proper footwear and/or plantar orthoses to prevent diabetic foot ulceration (primary prevention), to manage healing of an active ulcer, or to prevent ulcer recurrences (secondary prevention). In the following chapter, together with a literature review of the most recent peer-reviewed studies and position papers, we highlight the role of footwear intervention in diabetic foot care.