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Diabetic foot complications are costly and often recurrent. The use of diabetic footwear has been shown to be effective in reducing the incidence of diabetic foot ulcerations. For diabetic footwear to be most effective, it must be worn at least 60% of the time. All reported rates of compliance fall well short of this level. The style and appearance of the shoe have been commonly blamed for this poor compliance. This study evaluates patients’ motivations and perceptions regarding diabetic footwear. A patient’s decision to use diabetic footwear is based on the perceived value of the shoe and not on the patient’s previous history of foot complications or the aesthetics of diabetic footwear. (J Am Podiatr Med Assoc 93(6): 485-491, 2003)