Diabetic shoe inserts are different from shoe inserts used to support a flat foot or provide shock absorption for a high arched foot (orthotics). The inserts used for diabetics are primarily designed to protect fragile diabetic skin from excessive pressure forces due to standing and shearing forces due to foot movement within the shoe. These two forces, along with poorly fitting shoes, are a frequent cause of diabetic wounds and sores. These wounds and sores often lead to infection and possibly amputation if not treated in a timely manner. Prevention of these skin defects is of utmost importance, and the use of diabetic inserts is part of that preventative measure.
A diabetic insert is usually made from a material called plastizote, which is a type of specialty foam that can deform to the shape of the foot, allowing it to cradle areas of bone or foot prominence in order to protect them from pressure. Several densities of this material are used, along with a firmer material to provide backing and stability against the bottom of the shoe. The finished insert made from these materials allows the foot to stay stable inside the shoe, and drastically reduces excessive pressure and shear that can lead to skin damage. These materials are durable, but do need to be replaced a few times a year to preserve the protective benefit of their use. They can be used with a dedicated diabetic extra-depth shoe, or can be placed in most all standard lace-up or deep slip-in style shoes. Any diabetic with decreased foot sensation, prominent bones, calluses, or a history of foot wounds should be wearing these inserts.