Crocheting Diabetic Socks

This has been copied and pasted from my blog at hookey.org. I thought it might be useful to people here.

This is largely a marketing term, designed to sell someone socks at a higher price. Many socks not labelled “diabetic” can be worn by diabetics. So what is a diabetic sock? In order to be considered a diabetic sock, the socks must be:
Non-binding. Since circulation is affected in diabetics, the risk of ulcers is much higher than in those without diabetes.
Moisture control. Circulation issues can lead to bacterial and fungal infections. Keeping skin dry is desirable.
Seamless toe closure. Some diabetics have extremely sensitive skin and a toe seam rubbing against skin can cause blistering and irritation.

I have many, many diabetic pedicure clients in my practice as an esthetician. Most of them don’t require anything special in regards to their feet. However, at least half of all diabetics will develop what is called “neuropathy” and this is where the cause for concern lies.

If blood sugar levels are not controlled properly, then nerve damage occurs. This can happen all over the body, inside and outside, but it is most common in the feet because feet will receive blood with the least amount of oxygen and other nutrients for the necessary repair of everyday wear and tear and injuries that may occur. This is why foot injuries can sometimes take longer to heal in all of us, whether we have a metabolic disease or not. As neuropathy advances, diabetics lose the sensation in their feet. This is dangerous because they might not be able to sense that they have stepped on something sharp, that they are walking on too hot or cold of a surface – normal nerve sensation that we feel every day, which tell us something is wrong.

Now obviously a pair of socks can not cure this, but it is paramount for diabetics to protect their feet. Most of us do not take good care of our feet. We jam them into socks and shoes that do not fit, put on band-aids in anticipation of blisters that will occur while we “break in” our footwear and then we suffer later in life with foot problems that are largely preventable. Many of us in the Western world, are going to become diabetic in our middle age. In one small town in Nova Scotia, 100% of my elderly clients were Type II Diabetics, overweight or not, black, white, aboriginal, rich, poor – it did not matter. They were ALL diabetic.

When I taught esthetics in trade school, I emphasized to my students the importance of learning to treat diabetic (older) clients because this would be the reality of their practice in the years to come. I would advise sock makers who wish to sell their wares to consider marketing to such people as well. Many of my esthetic clients are aware that I crochet and several have asked for either sock patterns or pretty socks – most of my clients are also women If you go to Google Images, you will find that most diabetic socks are pretty blah. Socks are popular now, and people are more into adorning their feet in Western culture.

Here are the things that I take into consideration when designing a diabetic sock:
  1. Toe-Up Construction. One of the reasons that 99% of my sock patterns are toe-up is because so many of my recipients have been diabetic. Big seams can irritate sensitive toes, causing blisters. This can create an environment that allows bacteria and/or fungus to proliferate.
  2. Soft, stretchy yarn. When your nerves are degenerating, not only does it cause numbness and tingling, but it can also cause unpredictable moments of hypersensitivity. A yarn that feels ok against skin unaffected by neuropathy can feel like a wire brush again skin that is affected. Some fibres to think about are alpaca, superfine merino, cashmere, bison, qiviut, sea cell, corn fibre, bamboo, and cotton. Also very useful are sock yarns that have aloe lotion blended into them, especially when trying to prevent dry winter feet.
  3. The fibre must not inhibit the skin’s excretory process. Our skin is constantly getting rid of waste for us. We notice it most when we are sweating, but it is a function that is carried out at all times of our lives. Some fibres are very good about wicking moisture away from our bodies and some are good at holding moisture to us. I personally do not like acrylic yarn. I find that it does not hold its shape, and when used in sock construction, has no insulating or cooling properties to speak of.
  4. Custom shaping. We all have differently shaped feet, with their own lumps, bumps, and knots. This is why when I create a pattern I emphasize customization. Many diabetics have edema, and those with advanced neuropathy often have disfigured feet. Most socks are two straight tubes joined by a heel and this does not work for everyone. Make full use of short rows, increases, decreases, lace, and whatever other tricks are up your sleeve to craft a sock that fits. Remember, as I’ve said in years past, crochet socks look like Keebler Elf boots, so don’t worry about what your sock looks like when it isn’t on the foot. If it is shaped properly, then it will look absolutely fine when it is worn on the foot for which it was designed.
  5. The yarn must have good memory. Most plant fibres do not have as good a memory as animal fibres, but they are soft and slippery feeling. Choose a fibre that is somewhat curly in its natural state. This is what makes wool so useful because most of it has “body” or wave when it is on the animal. Curly hair when spun, makes for a garment that holds its structure. Blocking an item is no different than styling hair – you shampoo it, and then dry it in the way that you want it. Curly hair with a touch of coarseness holds a style better than straight slippery hair. My current favourite yarn for all of my socks is Corny Goodness’ 60/40 corn/wool blend. That doesn’t mean that other brands won’t work, just that this happens to be my favourite. This makes for an expensive sock for me, because the closest distributor is in Fargo, haha.
  6. The gauge should be as fine as you can muster. It is no secret that large gauge socks done in crochet can HURT. The first book I ever bought about crochet socks featured patterns all done in worsted weight yarn. When I put my socks on and walked around, I couldn’t believe how painful it was and I have some pretty tough soles because I live barefoot most of the time. I find that a gauge of 5 sts/1″ is as large as I want to go. The current pair that I am working on is at a gauge of 9 sts/1″ using lace weight baby merino and a 2.25mm hook.
  7. White, or light colours, are preferable for those who can not feel parts or all of their feet or lower legs. This is because drainage from new or old wounds can be detected when it seeps through and stains the fabric. Blood, lymph, and other body fluids associated with injuries aren’t going to be as obvious on a magenta kettled dyed sock as they will be on a flecked beige one.
  8. A touch of Lycra for stretch. A nice soft sock feels good against the skin but if it gets too baggy then it will rub and cause irritation. Yarns with a touch of Lycra can alleviate this. Be careful not to work too tightly with a stretch yarn. Sometimes it is better to go up a hook size or two. Pay attention to how the sock feels. I find that many stretchy socky yarns can be very uncomfortable even when crocheted in a fine gauge. Explore different brands until you find one that you like. If the recipient finds it does not feel nice, then consider reserving the stretch yarn for cuffs and working the rest of the sock in a non-stretchy yarn.
  9. Stay within 1/2″ of the wearer’s actual foot measurements. This way the sock isn’t too tight. I personally love negative ease in my socks, but when it comes to diabetic feet, the less negative ease, the better.
  10. Keep heavy texture to a minimum. You can use lace, posted stitches, and other elements to create a visually interesting sock, but keep in mind how the wrong side will feel against sensitive skin. In many cases, straight single crochet in a spiral round worked in a fine gauge is preferable for the foot, saving the fancy stuff for the leg.
  11. Keep colour changes to a minimum to avoid lots of little bulky areas where multiple ends are woven in. Lots of sock yarns come in beautiful muted variegated colourways that don’t require colour changes.
Above all, keep the recipient in mind. Try it on as you go, and be patient. There may be lots of ripping back, or pattern or yarn changes as you figure out what works and what doesn’t.
Happy Hooking!!!!!
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