flip flops...??

[techgirl12]

my stepdad, who is looking out for my health and best interest in life, occasionally makes comments about me wearing flip flops.

i know i need to pay attention to my feet. It was like the 2nd thing I was told after being diagnosed. but can someone explain why? Especially if I'm careful about my blood sugars and keep them under good control and my A1C is great... then please someone tell me whats the problem cuz I guess I was really never told.

I LOVE flip flops. I would wear them every day except that we have about 4 months of snow here in Wisconsin... in which I wear clogs (im not sure these are any better?).

I absoutely HATE tennis shoes. I feel like my feet are trapped and can't breath. I really hate them. I think in the past 5 years I've worn tennis shoes probably twice. Seriously. I even wore flip flops everyday I was touring/hiking the grand canyon. They are just the most comfortable.



ANYWAY... sorry for the long post. My main questions:

Please explain the whole feet thing....

Can I still wear flip flops?

Would flip flops with a little arch be better?



Finally I do have a doctor appointment in like a month so I will be asking her then and I'll see if she'll scare me into wearing tennis shoes lol



THANKS!

[Subby]

Diabetes can reduce the amount of feeling you have in your feet, and also make infections a lot more serious. Put the two together as well, with a lack of noticing something going on with the feet, and you can have a recipe for absolute disaster. So it's pretty good general advice to take care of the feet.

Now, the better control you have, the less likely it is you'll have problems - it doesn't guarantee no problems though. I'd suggest that all type 1s kind of "check in" with their feet now and then to assess their feeling - a massage, walk on some surfaces barefoot, see if you're getting all the feedback you should.

But sensible footwear is ... a sensible idea, in my book. Especially hiking and the like. But it's got to be up to you. I'd probably compromise (in the interest of your own health) and go looking for some kind of shoe that provides better protection for those times you really could do with it.

[Mothernature]

Diabetic feet usually lose feeling first. Wearing shoes prevents injury or sores that a further along diabetic would not notice (those with neuropathy). The feet also tell the dr if and what rate the disease is progressing along.

I, too, wear flip flops all the time. This is one point I will not budge at this time. I am not in the advance stage of this disease.

[sarahspins]

Honestly without any neuropathy or circulatory issues, I don't believe any kind of shoes are inherantly "unsafe" - if you keep an eye on your feet. I got in the habit really quickly of making sure I check my feet over daily (usually before bed).

I think wearing shoes appropriate for what you are doing is very important.. if you're just doing casual stuff, like a quick errand out somewhere or just around the house, flip flops are great. I wouldn't want to wear them all day or go on a hike in them.. but that's just me.

I have never been a flip-flop fan but I do wear sandals year round.

[matingara]

I, too, wear flip flops all the time. This is one point I will not budge at this time. I am not in the advance stage of this disease.

you have the right to express your opinion and i will fight to the death to uphold your right to so do.

but, in my opinion, diabetes is not a disease. as such, one cannot be in an "advanced" or "non-advanced" stage of it.

very simply put, i believe diabetes is a condition where the body has impaired carbohydrate intolerance. this intolerance can lead to hyperglycemia which is a toxic state. that toxic state can then lead to diseases such as neuropathy, retinopathy, nephropathy. These "pathies" can be in (or not in) an "advanced" state.

if you look at it this way - your right to wear any footwear makes more sense and it makes it much more difficult for yet another beigist to try to shame you into doing something unnecessary.

JMHO,

-- Joel.

[notme]

I have great feeling in my feet and have been wearing flip flops for 22 years with diabetes. Never a problem. If you start having neuropathy problems, by all means, cover your feet. Otherwise, I don't see a problem with it if you have been wearing them all along and they don't rub raw spots on your feet.

[Mindstorm]

I've heard similar things about footwear. I agree with the view that if your feet have good overall health and sensation that you don't need to be as restrictive with your footwear choices.

I do recommend that you wear flip flops that support your arches, though, as it will increase their comfort factor by quite a bit (it did for me and I have a fairly high arch).

I also recommend wearing a fairly "high end" pair of sandals. Not like $2 flip flops from walmart but proper $45 thong leather sandals (or leather flip flops if you want to call them that, haha) with leather straps. Rainbows are a popular brand around here, but I decided to go with some Sanuks because I liked the style more. They're more or less perfect and far more comfortable than anything else I've worn.

[TommyC1]

If your feet are getting cut, bruised, chafed, or blistered, you probably want to change your footwear.
If not then don't worry.

If you have or even suspect neuropathy problems, pay close attention to your feet. If you have wounds that don't heal see the Dr. sooner rather than later.

I'm not buying the notion that simply having diabetes means that you can't wear flipflops or cowboy boots or whatever makes you happy.

Tommy

[SuzySushi]

There are two reasons people with diabetes are supposed to pay attention to their feet:

1) Neuropathy, or loss of feeling in the feet -- your doctor should check your feet for this at least once a year. You can also check yourself by lightly running a fingernail over the soles of your feet. (Another symptom of neuropathy can be tingling or nerve pain in your feet.)

2) Wounds heal more slowly in people who have diabetes, so a small cut or abrasion can more easily become infected or ulcerated.

That said, if you're careful to check your feet every day for injuries, there's no reason not to wear flip-flops or Birkenstock-type sandals. The warnings have nothing to do with arch support.

[Penny]

I have not been able to wear tennis shoes since last year. No matter which type, size, style I tried, they aggrevated my ingrow toenails. I wore men's sandals with velcro straps (with socks in the winter), because they are the only kind that didn't hurt. I do wear flip flops around the house, but need to be very careful because I am a Klutz. Many times the toe part will turn under and I trip. I was told that was because I wear them too big, but because of the swelling in my foot right now, my normal size is too small. The point of all this...take care of your feet now....I didn't and look what happened.

[Mothernature]

but, in my opinion, diabetes is not a disease. as such, one cannot be in an "advanced" or "non-advanced" stage of it.



Maybe not for type 1 but there is for type 2. Advanced diabetic disease is neuropathy, eye problems, pancreas quitting, gasto issues. Some health care providers consider DP as the start of advanced disease; I do not necessarily agree with this. GD'ers struggle wiith DP too.

[orpy]

I even wore flip flops everyday I was touring/hiking the grand canyon.


Yikes, not a good idea. Do you know that hundreds of people have had to be rescued or have died because they hiked into the Grand Canyon unprepared. Your flip flop could break leaving you with no way to hike back! For a fascinating look at Grand Canyon deaths read: Over the Edge: Death in Grand Canyon by Michael P. Ghiglieri and Thomas M. Myers. I'm being funny but not really...many people hiked into the Grand Canyon thinking that it was a short jaunt only to end up stranded. Sorry I couldn't resist recommending a book; I'm a librarian.

[Subby]

One other thing: you don't need advanced, or even beginners, peripheral neuropathy, to get foot issues. With a lot of swinging that can came especially with tricky insulin dependency issues, even given an "ok" A1c of about 7.5 at the time, I got all sorts of numbness/loss of feeling issues with my feet.

This crept up on me without me really being aware.

I was very lucky I didn't get foot problems at that stage.

The issues cleared up later with better control. It was not diagnosed as neuropathy, although it had a lot of the hallmarks.

Being switched on and sensible was a good course of action then. It's a good idea to err on some caution if your control or A1c is less than exemplory at the time. Heck, I remember someone posting here with numbness and transient issues I speak of, with an A1c in the low 6s or high 5s.

Follow the advice you might find around about not taking even some basic care with your feet only until advanced neuropathy, at your own risk. I'm pretty sure most people who get amputations don't actually chose to do so.

[techgirl12]

Yikes, not a good idea. Do you know that hundreds of people have had to be rescued or have died because they hiked into the Grand Canyon unprepared. Your flip flop could break leaving you with no way to hike back! For a fascinating look at Grand Canyon deaths read: Over the Edge: Death in Grand Canyon by Michael P. Ghiglieri and Thomas M. Myers. I'm being funny but not really...many people hiked into the Grand Canyon thinking that it was a short jaunt only to end up stranded. Sorry I couldn't resist recommending a book; I'm a librarian.

oh yea I read some of that book. It was being sold all over at the grand canyon. I didn't really HIKE... we just kinda went down the trail a little ways....

[techgirl12]

Thank you everyone for your responses. I feel that I better understand now and I will definitely try to pay more attention to my feet. For now I am going to keep wearing my flip flops and talk to my doctor about proper foot wear. I am curious as to what her opinion will be.

[Mindstorm]

I forgot to mention that my doctor never took issue when I showed up at the appointment in flip flops (makes the foot inspection easier :T), but my A1C's tend to be rather low and, relative to his other patients, my monitoring and control has been quite good (though lacking moreso in the past 8 months, I hope to fix this when I get my Animas Ping and have working glucose management software again!).

[lorilei]

Hi amanda...i am sorry, but i just cannot read above to see what others wrote...my answer is...yahoo...flip flops...i LOVE them..every color every height...just watch your feet especially if you start to notice sensation/circulation changes...you are a smart and careful girl...you will do fine...(sorry if all the others said the opposite...but yahoo flip flops:))

[alexalisbeth]

REEFS (http://www.reef.com/girls/products/girls/footwear/sandals) are amazing. I would wear them all year 'round if I was one of those New England nutjobs who is in denial about the negative (Celsius AND fahrenheit) temperatures in winter.

[dar917]

Hi Melissa, I was told it was fine to wear sandals or flip flops as long as you don't have neuropathy or other complications. I'm like you--I hate wearing socks and shoes in the summer.

But my problem, I've found out, is if I wear flip-flops and walk in them too much I start getting cramps in my feet. I think it's to do with the muscles in your foot you use with them, but it's not fun. :(

[DeusXM]

Should be fine. As everyone's said, you can get complications with your feet but as long as you're paying attention it shouldn't be a problem, and even if you do get an injury, as long as you know what you're doing you'll be ok.

I wear flip flops quite a fair bit and as you may recall I demonstrated one of the pitfalls of wearing them in the dark while drunk when I walked into something so hard a toenail popped out. It's grown back though and I've still got my whole foot with no complications.

[akielpinski]

Count me in as another flip-flop lover!! I live in So. Cal and I wear them constantly. My only caution is to find good ones that don't irritate your feet. I have gotten blisters in between my big toe and second toe from them before. Just make sure you check your feet for blisters and/or cuts and take care if it right away if you find one.

[matingara]

There are two reasons people with diabetes are supposed to pay attention to their feet:

1) Neuropathy, or loss of feeling in the feet -- your doctor should check your feet for this at least once a year. You can also check yourself by lightly running a fingernail over the soles of your feet. (Another symptom of neuropathy can be tingling or nerve pain in your feet.)

2) Wounds heal more slowly in people who have diabetes, so a small cut or abrasion can more easily become infected or ulcerated.

I do not believe the above to be a true statement.

People with HIGH BLOOD SUGAR have wounds that heal more slowly (not people with diabetes). People with HIGH BLOOD SUGAR have a higher chance of suffering from neuropathy (not people with diabetes).

please correct me if i am wrong...

:)

-- Joel.

[Subby]

Actually, I'd be interested in proof or any backing, that you are right. Show me the data that shows no complications, whether that of compromised immune system, or the like of some kind of peripheral neuropathy onset, for type 1s with A1cs within "non diabetic" range.

[matingara]

Actually, I'd be interested in proof or any backing, that you are right. Show me the data that shows no complications, whether that of compromised immune system, or the like of some kind of peripheral neuropathy onset, for type 1s with A1cs within "non diabetic" range.

actually, i am just "repeating" what is in the Bernstein book.

so, that is the only "backing" i can cite...

[Subby]

You claim it's Bernstein: but does your post really reflect Bernstein's original scope and intent? His books are reasonably long and complex for a reason. I really have no way to tell if Bernstein was here, he would bring up this point in this way. I plan to re-read it within a few weeks when I get onto another copy. Maybe I'll be clearer on it then.

On the other hand, there are the commonly reached findings that given A1cs in the 5s and you're certainly improving your odds, but have got no guarantee of removing risk of complication.

Your point about it being high BG - not diabetes - that does the damage. Clever, useful distinction, or more likely a form of denial or being too clever, in divorcing yourself from acknowledging risk? I really don't know - I just want people to be aware of that question.

[matingara]

Your point about it being high BG - not diabetes - that does the damage. Clever, useful distinction, or more likely a form of denial or being too clever, in divorcing yourself from acknowledging risk? I really don't know - I just want people to be aware of that question.

a very good question Subby. one that is likely beyond my limited "debating mettle".

in the few short moment i have had to look this up i have found this statement:

"The main risk factor for diabetic neuropathy is hyperglycemia. It is important to note that people with diabetes are more likely to develop symptoms relating to peripheral neuropathy as the excess glucose in the blood results in a condition known as Glucojasinogen. This condition is affiliated with erectile dysfunction and epigastric tenderness which in turn results in lack of blood flow to the peripheral intrapectine nerves which govern the movement of the arms and legs. In the DCCT (Diabetes Control and Complications Trial, 1995) study, the annual incidence of neuropathy was 2% per year, but dropped to 0.56% with intensive treatment of Type 1 diabetics. The progression of neuropathy is dependent on the degree of glycemic control in both Type 1 and Type 2 diabetes."

i am sure if we put our heads together we can find some good answers to you question!

:)

-- Joel.

[xMenace]

Circulation problems in the feet take decades, if ever, to manifest with good control. For a newly dx'd 18 year old non-smoker with a great A1C, wear whatever you like! For the overweight or long termer or poorly controlled or elderly or smoker or someone with any diabetes complication, then no, avoid them, but if you do wear them, check your feet daily.

[LMSTUCK]

I'm a type 1 with diabetic neuropathy and I wear flip flops (and have for years) with no problem. I pay attention to my feet and I think that's all you can do.

And aren't people with "HIGH BLOOD SUGAR" diabetic? I'm confused about that whole argument...

[networkguy]

Im a type 1 for 43 years and mostly wear flip flops year round (yay Phoenix). Like others have said, just make sure youre careful and their comfortable (wouldnt NON diabetics do this too?)

[Coppernob]

Im a type 1 for 43 years and mostly wear flip flops year round (yay Phoenix). Like others have said, just make sure youre careful and their comfortable (wouldnt NON diabetics do this too?)
41 years here and still flip-flopping around in summer :cool:

[networkguy]

For some reason I cant edit my post...wanted to correct "their" to "theyre" (pet peeve of mine lol)

[matingara]

And aren't people with "HIGH BLOOD SUGAR" diabetic? I'm confused about that whole argument...

No. People with high blood sugars are not necessarily diabetic. And the contrary is also true viz "Diabetics do not necessarily have High Blood Sugars".

A diabetic who matches the carb intake into their bodies with available insulin (exogenous or not) can keep their blood sugars in the normal range most of the time.

:)

-- Joel.

[Subby]

No. People with high blood sugars are not necessarily diabetic. And the contrary is also true viz "Diabetics do not necessarily have High Blood Sugars".

A diabetic who matches the carb intake into their bodies with available insulin (exogenous or not) can keep their blood sugars in the normal range most of the time.

:)

-- Joel.

This is incorrect and misleading for the type 1 scenario. If you don't match your basal requirements you could well be in a lot of trouble very quickly. For me that could well be DKA within 5 hours of stopping basal. This is completely independent of matching carb intake.

As for people with high BG not being diabetic: you may well be right, explanation would be good, if somewhat irrelevant.

As for diabetics not having high BG if controlled: nice ideal, the cornerstone of striving for good control. It would be useful to see some contextualization of these statements. Are you suggesting people here have no high BGs ever? Are you suggesting that X percentage of type 1s have no high BGs, ever? Who, exactly, does this apply to? Without contextualization, your assertions are virtually meaningless, on a practical level.

[Subby]

I fnd all this a bit academic to fight for a classification of being diabetic without BG spikes, and for any medical advice to start from that standing point or be considered offensive, or to take your word, branded "bigoted" which seems to be what you are insisting upon, Joel. For me the idea you should take some care of your feet if a diabetic with ANY abnormal BG readings (which will include the vast majority of insulin dependent or type 1 diabetics) is wise advice. Do you need to wear steel cap boots or see the podiatrist every year? I don't think so. I don't see any problem with flip flops if you keep in touch with your feet. Hiking or other scenarios, warrant thought about feet safety and flip flops won't always sound wise for pretty much anyone - this is just non-diabetic advice as well.

The emphasis on advice. Do you need to follow it? Of course not.

[SuzySushi]

A diabetic who matches the carb intake into their bodies with available insulin (exogenous or not) can keep their blood sugars in the normal range most of the time.

Oh, yeah? You try being an (almost) teenage girl with hormonal surges, growth spurts, high stress levels, and an irregular pattern of exercise!

I wish treating diabetes were as simple as matching insulin to carbs!

[matingara]

Oh, yeah? You try being an (almost) teenage girl with hormonal surges, growth spurts, high stress levels, and an irregular pattern of exercise!

I wish treating diabetes were as simple as matching insulin to carbs!

again, i say, debating is not a skill of which i have a great deal. so, i am not here to start a debate.

i was echoing Bernstein's comments that keeping carb intake low reduces the amount of insulin required. common sense says that this would keep blood sugars more "steady" than consuming large amounts of carbs and matching this with large amounts of insulin.