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Socks Can Be Therapeutic For People With Diabetes
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Socks Can Be Therapeutic For People With Diabetes
By Douglas H. Richie, D.P.M.
Protecting the foot from injury and infection is of critical importance for the patient with diabetes. Loss of sensation, reduced circulation, and delayed wound healing are all potential complications of diabetic foot disease. The first line of protection from these complications can be a specifically and properly designed sock, which has continuous direct contact with the skin of the foot throughout the day.
Until recently, advice given to patients regarding socks was aimed at avoiding potential harmful effects rather than seeking protective benefit. Medical research has shown that such advise is based on erroneous assumptions that could actually cause negative results for diabetic patients.
Elasticized form-fitted socks won't slide down the ankle or wrinkle inside the shoe. At the same time, a form-fitted sock with a mild amount of compression can promote circulation and reduce swelling. It is nearly inconceivable that a sock could restrict incoming circulation to anyone's foot. In order to develop enough pressure to restrict arterial inflow, a sock would have to be so tight fitting it would be impossible to slide onto a person's foot. The "red line" commonly seen on the skin of the leg of a patient with edema is caused by improperly designed socks that have an elasticized ridge at the top. Properly made socks for a diabetic should have an upper with minimal elastic at the top to avoid such a skin irritation.
The recommendation of cotton socks for diabetic patients is also erroneous. Compared to newer synthetic fibers, such as, Duraspun™ acrylic, cotton fibers compress, lose shape, and remain wet inside of the shoe. Cotton fiber socks are also rough and become abrasive with multiple wash-wear cycles.
Therefore, for a sock to be protective or therapeutic for the diabetic foot, it should:
Contain synthetic moisture wicking fibers such as Duraspun™ acrylic or Coolmax™ polyester to remain soft and provide cushion. Cotton fiber socks should be avoided for patients with diabetes.
Be form-fitted and snug (not tight), with sufficient elasticity to prevent the sock from slipping into the shoe, while staying up on the ankle.
Have no harmful dyes or additives against the skin.
Be worn in properly fitted shoes.
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