When most people think about diabetes, they focus on managing blood sugar, diet, and medication — but one often-overlooked area is toenail health. For individuals living with diabetes, even something as simple as trimming toenails or dealing with a small nail infection can become complicated and risky. That’s because diabetes affects circulation, nerve function, and the body’s ability to heal — all of which play major roles in keeping your toenails and feet healthy.
Understanding the connection between diabetes and toenail health is key to preventing infections, avoiding complications, and maintaining overall foot wellness. We’d like to thank our friends at Dynamic Foot and Ankle Center for the following post about the connection between diabetes and toenail health.
How Diabetes Affects The Feet And Toenails
Diabetes can lead to several changes in the body that directly impact toenail and foot health:
- Poor Circulation (Peripheral Arterial Disease)
High blood sugar levels damage blood vessels over time, leading to reduced blood flow to the feet and toes. When circulation is limited, the nails and surrounding skin receive less oxygen and nutrients, slowing nail growth and healing.
- Nerve Damage (Diabetic Neuropathy)
Diabetes can damage nerves in the feet, causing numbness, tingling, or burning sensations. This loss of feeling means minor nail problems, such as ingrown toenails or infections, can go unnoticed until they worsen.
- Weakened Immune Response
High blood sugar impairs the body’s ability to fight infections. Even a small cut near a toenail or a fungal infection can progress quickly without proper care.
- Dry Skin and Cracking
Diabetes often leads to dry skin and thickened toenails, which can split or break more easily. Cracked skin around the nails can allow bacteria or fungi to enter, increasing infection risk.
Common Toenail Problems In People With Diabetes
People with diabetes are more prone to toenail issues — some of which can become serious if left untreated.
- Fungal Nail Infections (Onychomycosis)
This is one of the most common nail problems among diabetics. Fungal infections cause nails to become thick, yellow, brittle, and difficult to trim. They can also lead to pressure sores or skin infections if the nail grows irregularly.
- Ingrown Toenails
When a nail grows into the surrounding skin, it can cause pain, redness, and swelling — and if not treated properly, it can become infected. People with diabetes are especially at risk since neuropathy may prevent them from feeling early warning signs.
- Thickened or Discolored Nails
Changes in nail thickness or color may result from poor circulation or fungal growth. Thick nails can press against shoes, causing discomfort or sores beneath the nail.
- Nail Trauma or Slow Healing
Even minor injuries from trimming nails too short or bumping your toes can take longer to heal and may lead to infections.
- Paronychia (Nail Fold Infection)
This bacterial infection occurs around the edge of the nail and can cause pain, redness, pus, and swelling. In people with diabetes, paronychia can escalate quickly without prompt care.
The Risks Of Ignoring Toenail Problems
Ignoring nail issues may seem harmless, but for someone with diabetes, it can have serious consequences. What begins as a small nail infection can lead to:
- Ulcers or open sores around the toenail
- Cellulitis, a bacterial skin infection
- Osteomyelitis, a bone infection
- Gangrene, if tissue dies due to lack of blood flow
In severe cases, untreated infections can even result in amputation. That’s why maintaining toenail health is a vital part of diabetes management — not just an aesthetic concern.
Proper Toenail Care For People With Diabetes
Good foot and nail hygiene can go a long way in preventing complications. Here are essential tips for keeping your toenails healthy:
- Inspect Your Feet and Nails Daily
Check for redness, swelling, cuts, or changes in nail color or texture. Use a mirror to see the bottoms of your feet or ask for help if needed.
- Wash and Dry Thoroughly
Clean your feet daily with mild soap and warm (not hot) water. Dry completely — especially between the toes — to prevent fungal growth.
- Trim Toenails Carefully
Cut nails straight across and avoid cutting too short or rounding the corners. Use clean, sanitized tools. If your nails are thick, hard to reach, or difficult to trim safely, schedule regular visits with a podiatrist.
- Keep Nails Smooth
Use a nail file to gently smooth rough edges and prevent snags that could tear the skin.
- Wear Proper Footwear
Choose shoes that fit comfortably, with enough room for your toes to move freely. Avoid tight shoes or high heels that put pressure on your nails.
- Control Blood Sugar Levels
Stable blood sugar helps maintain healthy blood flow and boosts your immune system, reducing the risk of infections.
- Avoid Nail Salons Without Medical Oversight
Traditional nail salons may not follow medical-grade sterilization protocols. It’s safer for people with diabetes to have nails trimmed by a podiatrist or a foot care specialist trained in diabetic care.
- Moisturize Regularly
Apply lotion to your feet and around your nails to prevent dryness and cracking — but avoid between the toes, as excess moisture can promote fungal growth.
When To See A Podiatrist
You should schedule an appointment with a podiatrist if you notice:
- Thickened, discolored, or brittle nails
- Redness, swelling, or pus around a nail
- Pain or tenderness in the toenail area
- Foul odor from the nail
- Nails growing into the skin
- Cuts or sores that don’t heal within a few days
A podiatrist can safely trim thickened nails, treat infections, and identify early warning signs of more serious issues like ulcers or circulation problems. They may also recommend antifungal treatments, custom orthotics, or special diabetic footwear to prevent pressure and friction.
The Role Of Podiatric Care In Diabetic Nail Health
Regular podiatric care is one of the most effective ways to prevent diabetic nail and foot complications. Podiatrists not only treat existing nail problems but also focus on prevention by:
- Monitoring circulation and nerve health
- Removing corns, calluses, and thickened nails safely
- Educating patients on home care and shoe selection
- Providing custom orthotics to relieve pressure points
By seeing a podiatrist at least once a year — or more frequently if you have existing nail or foot issues — you can detect and treat problems early before they become serious.
Maintaining Healthy Toenails With Diabetes
Diabetes affects far more than blood sugar — it influences every part of your body, including your toenails. Because poor circulation and nerve damage make your feet more vulnerable, regular care and attention are essential.
With daily foot checks, safe nail care practices, and routine visits to a podiatrist, you can prevent complications, maintain strong healthy nails, and preserve your mobility.