The Shoes I Actually Wear: A Longtime T1D's Take on Footwear
A practical guide to choosing shoes with Type 1 Diabetes — written by someone who has been watching his feet for signs of neuropathy for four decades. Real features to check, honest brand notes, and why shoes are the cheapest insurance policy your feet will ever have.
Why your shoes are a T1D decision
If you’re newly diagnosed with Type 1 Diabetes, this article might feel like it came out of left field. Shoes? Really? Of everything I could write about in my 43rd year with this disease, I’m writing about footwear?
Yes. Because here’s the thing nobody puts on the cover of the diagnosis pamphlet: the place where long-duration T1D does its most expensive damage is your feet. Not your eyes, although it gets your eyes. Not your kidneys, although it can. The feet are where the slow complications converge — peripheral neuropathy, reduced circulation, delayed wound healing, and a nerve system that quietly stops sending pain signals to your brain. A small blister you can’t feel becomes a sore you don’t notice becomes a wound that doesn’t heal becomes the kind of medical crisis that shortens lives.
And the first line of defense against all of that is not a medication. It’s the pair of shoes you put on before you leave the house.
A recent diaTribe Foundation piece walked through the general recommendations from podiatrist Dr. Samantha Landau, and it’s a solid reference. I want to add the 43-year T1D version — what I actually wear, what I check for, and what I have learned to walk away from.
What diabetes does to your feet (and why this matters earlier than you think)
The short version of the biology:
- Peripheral neuropathy — roughly half of people with diabetes eventually develop some form of nerve damage in their extremities. Tingling and numbness in the feet are the classic early signs. If you lose protective sensation, you can step on something sharp, burn your foot on hot sand, or rub a blister into your skin — and not notice until the damage is visible.
- Reduced microcirculation — blood vessel damage makes it harder for oxygen and nutrients to reach the tissue in your feet. Small injuries take longer to heal. Infections are more likely to get a foothold.
- Swelling from fluid retention — when circulation is poor, fluid pools in the ankles and feet. A shoe that fit perfectly at 8 a.m. can be painfully tight at 6 p.m.
Even if you don’t have any of these complications yet — and I, fortunately, don’t have diagnosed neuropathy four decades in — the calculus of shoe choice changes the moment you’re diagnosed. You are now playing for margin. Every pair of shoes is either widening your margin of error or narrowing it.
The seven things I actually check for
The diaTribe piece lists the clinical checklist from Dr. Landau. Here is the personal, been-there-four-decades version of the same list.
1. Wide, deep toe box — not optional
The single most common shoe mistake I see people make is buying a shoe that looks good at the expense of the toe box. A narrow toe box squeezes your toes together, builds calluses on the outside of your little toe and the side of your big toe, and sets up the exact kind of friction wound that a T1D foot can’t afford.
The test I actually use in a store: pull the insole out of the shoe, put it on the floor, and stand on it. If any part of your foot hangs over the edges of the insole, the shoe is not wide enough. It doesn’t matter what the label says.
2. Firm heel counter
Press your thumb against the back of the shoe where your heel sits. It should not collapse. The heel is the only anchor your foot has inside the shoe — if it slides, you are creating friction, and friction on a diabetic foot is what blisters are made of.
3. Cushioning that you can actually feel
I want insoles I can push my thumb into. Thin-soled “minimalist” running shoes are a cultural trend that is, in my opinion, a bad match for most people with long-duration T1D. You need the shock absorption, and you need removable insoles so you can replace them when the cushion breaks down (which it does, usually around month nine of daily wear).
4. Torsional stability
Grab the toe of the shoe with one hand and the heel with the other and try to twist them in opposite directions. A good shoe resists this. A cheap shoe twists like a wet towel, and when you’re walking on uneven ground, that twist is your ankle’s problem.
5. Adjustability — laces or straps
Foot swelling is real, and it happens across a day, not just across a season. Your shoes need to accommodate it. I personally won’t buy a walking shoe without laces, because laces give me the ability to loosen the mid-foot in the afternoon and tighten it back up in the morning.
6. A seamless interior
Run your hand along the inside of the shoe. If you can feel a seam, a stitch, or a ridge, imagine that ridge pressing into a neuropathic foot for eight hours straight. That is how diabetic foot ulcers start — from a rub you never noticed because your nerves stopped telling you about it.
7. A “first-wear” comfort test
The single best piece of advice in the diaTribe piece is this: “Shoes should fit well from the start and not require a ‘break-in’ period.” I want to emphasize this because the entire marketing culture of dress shoes, leather boots, and “they’ll stretch” is a culture built for feet that can still feel pain. You do not have that luxury anymore. If the shoes are not comfortable the second you put them on in the store, they are not your shoes.
What I actually wear — my T1D shoe rotation
Here is what’s in my closet right now, after a lifetime of quiet experimentation.
Daily walking: a cushioned running shoe
I currently wear a pair of Hoka Bondi walking shoes for most daily wear. The stack height is absurd, the cushioning is obvious, and the toe box is wide enough that my foot can actually spread. I do not run in them — I walk, and I stand on them for most of a day, and my feet thank me for it. Brooks Ghost and New Balance 880 are honest alternatives in the same category. The common thread is max cushion, wide last, removable insole.
Weekend / casual: the same thing, in a darker colorway
I stopped trying to look cool in shoes a long time ago. My “weekend shoe” is the same category as my daily shoe, just in black. That is not a fashion surrender — it’s an acknowledgment that feet don’t know what day of the week it is and still need the same protection.
Dress shoe: leather, wide, adjustable, and honest about it
When I need to wear a dress shoe — weddings, funerals, a client meeting that demands it — I wear Ecco leather walking derbies. They are soft from the first wear, they lace rather than slip on, and the insole is removable so I can swap in a cushioned orthotic if I’m going to be on my feet all night. I will never again own a dress shoe I need to “break in.”
Winter boot: Gore-Tex, Thinsulate, aggressive lugs
If you’re spending time in cold or wet conditions, the clinical checklist gets stricter, not looser. I wear Merrell Moab winter boots with Gore-Tex membranes and Thinsulate insulation, and I pair them with merino wool socks. The diaTribe piece recommends Sorel, Columbia, Kamik, and The North Face — all solid calls. The common thread is waterproof membrane, insulated upper, deep lugs for traction on ice.
What I will not wear
- Flip-flops outdoors. One scrape between the big toe strap and the webbing, and I’m in a world of trouble.
- Cheap slides. Same reason.
- Anything labeled “minimalist” or “barefoot.” The whole premise is the opposite of what a T1D foot needs.
- Leather cowboy boots that pinch in the toe box, even though I love the way they look. I tried, once. It wasn’t worth it.
The socks conversation nobody wants to have
Socks matter more than most people think.
- Seamless. A stitched seam across the top of the toes is the single most common shoe-adjacent source of rubbing I see. Seamless socks cost two dollars more per pair. Pay it.
- Moisture-wicking. Cotton gets wet and stays wet. Wet skin macerates and breaks down faster than dry skin. Merino wool or synthetic blends are worth it.
- Cushioned at the ball and heel. You can feel the difference immediately.
- Not too tight at the cuff. If a sock leaves a deep indent around your calf at the end of the day, the elastic is restricting circulation. That is the exact opposite of what you want.
- Compression socks — maybe. Dr. Landau notes that compression socks can help with swelling and circulation, especially if you’re on your feet or sitting for long periods. I wear 15–20 mmHg compression on travel days and long work days, and they’re worth the investment. But if you have severe neuropathy or a history of ulcers, talk to a podiatrist before adding compression — you don’t want to mask a problem you can’t feel.
The red flags that mean you stop reading articles and go see a podiatrist
I am not a clinician. But there are patterns that any long-duration T1D patient learns to notice. If you have any of these, this article is not the right place to get your answer. A podiatrist is.
- A cut or blister on your foot that hasn’t healed in two weeks
- Persistent numbness, tingling, or a “pins and needles” feeling in your feet
- A warm, red area on the foot with no memory of an injury (this can be an early sign of a Charcot foot, which is a medical emergency)
- A callus that is cracking, bleeding, or changing color
- Any wound with drainage, odor, or surrounding redness
Foot ulcers are one of the most serious, most expensive, and most preventable complications of diabetes. The pair of shoes you choose and the early attention you pay are the two cheapest interventions in the entire disease.
The cheapest insurance your feet will ever have
Here is what four decades have taught me about footwear with Type 1 Diabetes, in one sentence: the shoe is the first medical device your feet ever meet, and you should treat it that way.
Buy one good pair. Replace them when they stop supporting you — not when they look worn out. Keep an eye on your feet every night the way you keep an eye on your glucose every hour. Call a podiatrist the first time something looks off, not the third.
You’re going to walk a lot of miles in this disease. The shoes are the cheapest thing standing between you and the complications. Spend the money.
— John Chitta
This article builds on the diaTribe Foundation’s Best Shoes for People With Diabetes, which compiled expert recommendations from Dr. Samantha Landau of Touro University. Brand mentions are personal preferences based on lived experience, not sponsorships or endorsements. Always consult a podiatrist or qualified healthcare provider about footwear if you have neuropathy, a history of foot ulcers, or any unresolved foot pain.
References
- Best Shoes for People With Diabetes · diaTribe Foundation
- Foot Care in Diabetes — Standards of Care 2025 · American Diabetes Association
- Diabetic Foot Problems — Overview · NIDDK / National Institutes of Health
- Diabetic Peripheral Neuropathy · American Diabetes Association
- How to Prevent Diabetic Foot Ulcers · MedlinePlus / U.S. National Library of Medicine