Objective
To assess the proper type of outsole for the diabetic shoes according to the hardness of outsole in diabetic patients.

Method
Seventeen diabetic patients and 33 normal control volunteers in the 5∼6th decade were participated in this study. Walking exercise in the treadmill was performed in all subjects wearing the custom-made shoes with the two layers of hard outsole and one layer of soft outsole, respectively. Peak plantar pressures were measured after exercise by Pedar system with pressure sensitive insoles inserted in each shoes and compared with two types of outsoles. The degree of oxygen saturation was measured in the fourth toe by Oxysensor and the plantar thermography were measured by infrared thermometer before and after exercise, and compared with the two types of outsoles in diabetic and control groups, respectively.

Results
There were not significant differences of peak plantar pressures in all measuring points according to the type of outsole in diabetic group. The degree of oxygen saturation in the fourth toe was not significantly changed between the two types of outsoles before and after exercise in diabetic group. The plantar temperatures were significantly increased after exercise in all groups, but there was not significant difference according to the type of outsole.

Conclusion
There was not significant difference between hard and soft outsole with the custom-made shoes for diabetic patient applied in this study. But more advanced studies about the outsole of diabetic shoe should be needed. (Korean Acad Rehab Med 2002; 26: 598-605)