Diabetes can affect various parts of your body, including your feet and toenails.
The different foot and toenail problems that it causes can range from mild to severe, and in some cases, these problems may require treatment from your doctor.
In this article, we will discuss the impact diabetes has on toenails and feet, as well as the treatment options available for those affected by diabetic foot and toenail problems.
We will also cover when you need to see your doctor for treatment and give you tips to help avoid needing treatment.
What is diabetes?
Diabetes, also called diabetes mellitus, is a chronic condition that affects the way your body metabolizes your blood sugar called glucose.
After you eat or drink something, your body converts whatever was consumed into glucose that gets absorbed into your bloodstream.
The hormone insulin is then used by your cells to convert glucose into energy.
There are two main types of diabetes and they are type 1 diabetes, which is usually diagnosed in childhood, and type 2 diabetes, which is typically diagnosed in adulthood.
Type 2 diabetes is when your body develops insulin resistance and can often be controlled with diet and exercise, but type 1 diabetes requires lifelong treatment with insulin as your body no longer produces it.
If you have uncontrolled diabetes it can cause serious health complications including heart disease, stroke, kidney disease, and blindness.
What are the symptoms of diabetes?
The symptoms of diabetes can be different for everyone and sometimes there may not be any symptoms at all. The most common symptoms of diabetes include:
- Increased thirst
- Increased appetite
- Unexplained weight loss even when eating more
- Frequent urination
- Fatigue
- Weakness
- Blurred vision
- Slow healing wounds
- Irritability
- Mood swings
- Increased risk of infection (both bacterial infections and fungal infections)
If you experience any of these symptoms it is important to speak with your doctor as they can often be managed with lifestyle changes or medication.
How does diabetes affect the feet and toenails?
Diabetes can create a variety of problems in the feet and toenails and most of them are caused by diabetic neuropathy, peripheral artery disease, and fungal infections.
Diabetic neuropathy, also called diabetic peripheral neuropathy, is one of the leading causes of problems with your legs and feet.
It occurs when high blood sugar levels cause nerve damage in your feet and legs that can lead to pain, tingling, or numbness.
The lack of sensations can make it difficult for you to detect any wounds or sores on your feet which may result in an infection and subsequently amputation.
Peripheral artery disease (PAD), also known as peripheral vascular disease or peripheral arterial disease, is when diabetes narrows the blood vessels in your legs and feet which can lead to leg pain when walking.
It causes poor blood flow and can make it difficult for your wounds to heal and gives you a greater risk for infection too.
Fungal infections of the toenails and feet are also more common if you have diabetes due to your increased risk of infections.
What are the diabetic foot and toenail problems caused by diabetes?
The most common problems caused by diabetes include:
Foot ulcers
These are open sores on the feet that can become infected. Diabetic foot ulcers are usually caused by a combination of diabetes, peripheral artery disease, and diabetic neuropathy.
Bunions
A bunion is when the big toe joint sticks out at an abnormal angle and often causes pain. Bunions are more common if you have diabetes due to the increased risk of foot problems and not being able to feel them.
Calluses and corns
Calluses and corns are areas of thickened skin that can form on the feet from rubbing or pressure and they often cause pain when walking or wearing shoes.
Athlete’s foot
Athlete’s foot is a fungal infection that thrives in moist environments.
If you have diabetes you are more susceptible to developing athlete’s foot because diabetes can cause decreased blood flow to the feet and slow healing of wounds or cuts which can create the perfect environment for fungus to grow.
The most common symptoms of athlete’s foot are itchiness, redness, and scaling on the feet.
Toenail fungal infection
Toenail fungal infections are also more common with diabetes as the fungus that grows thrives in moist and warm environments.
The most common symptom of a toenail fungal infection is a yellow or discolored toenail.
If you have diabetes and notice any changes in your toenails or think you have an infected nail it is important to speak with your doctor as soon as possible.
Diabetic blisters
Diabetes also puts you at risk for diabetic blisters which are also called bullosis diabeticorum, or diabetic bullae. They are large, fluid-filled blisters that usually occur on your feet and are not painful.
They are most common on the toes or soles of the feet and they heal on their own but if you have diabetes it is important to monitor them closely as they can become infected.
If you have a blister seek medical attention from your doctor or podiatrist (foot doctor) and do not puncture or pop them yourself.
Plantar warts
Plantar warts are growths on the soles of your feet that are caused by a virus and can be painful. Plantar warts can often go away on their own but if they do not, there are treatments available.
Dry skin
Diabetes can cause changes in your skin that make it drier and more prone to cracking. Cracked skin can lead to infections so it is important to keep your feet moisturized.
Hammertoes
Due to a lack of feeling in your feet from diabetic neuropathy you also run the risk of foot deformities like hammertoes. Hammertoes are when the toes bend at the middle joint and can become painful.
Ingrown toenails
An ingrown toenail is when the nail grows into the skin around it. If you have one, it can be painful and cause swelling and redness.
What are the complications caused by diabetic foot problems?
Some common diabetes complications are caused by these problems and they include:
Charcot foot
Charcot foot, or neuropathic arthropathy, is a foot complication that can occur with diabetic neuropathy. It is caused by the loss of feeling in your feet which can lead to deformities and fractures.
Charcot foot often starts with a foot injury that goes unnoticed because of the lack of feeling. The injury then progresses and the foot starts to change shape.
Charcot foot can be difficult to treat and often requires surgery.
Infections
Foot ulcers, plantar warts, and Athlete’s foot are all foot infections that can often lead to more serious complications and can lead to amputation.
Amputation
One of the most serious complications of diabetes is amputation. Amputations are often necessary when diabetes leads to an infection that will not heal or when there is severe nerve damage.
Deformities
As noted above, deformities of your feet and toes are also possible like Charcot foot, claw foot, hammertoes, and bunions.
Abscesses
An abscess is a pocket of pus that can form under the skin. It is often caused by an infection and can be painful. If you have diabetes and develop an abscess it is important to seek medical attention as they can often lead to more serious infections.
Gangrene
Gangrene is a serious medical condition and you need to seek medical care immediately if you have it. If you have gangrene, the blood flow to an area of your body is cut off and the tissue dies. Gangrene often leads to amputation.
What are the treatment options for diabetic foot and toenail problems?
Treatment for diabetic foot and toenail problems will vary depending on the problem. Treatment options include:
- Surgical treatments like surgical debridement where the diabetic foot ulcer is cleaned and any dead or infected tissue is removed
- Antibiotics for bacterial infections
- Antifungal medications for fungal infections
- Topical treatments
- Changes in footwear including custom orthotic insoles which are shoe inserts that can help your feet
- Wound care
- Amputation
Please talk to your doctor or podiatrist to determine the best treatment options for you.
When do I need to see a doctor about diabetic foot problems?
If you have diabetes it is important to see your doctor or podiatrist at least once a year for a diabetic foot exam. You need to also see your doctor right away if you have any foot problems such as:
- An open sore
- A cut or scrape that is not healing
- Redness, swelling, or drainage from a wound
- Ingrown toenails
- Corns or calluses
- Warts
- Ingrown toenails
- A change in the shape of your foot such as bunions, hammertoes, or Charcot foot
- Numbness or loss of feeling in your feet
- Pain in your feet
- Skin discoloration including the blackening of your skin
- Nail infections such as the yellowing or thickening of your nails
- Skin infections
If you have any of these problems it is important to see your doctor as soon as possible for medical treatment and to prevent further complications.
Are there ways to prevent these problems from occurring?
There are several things you can do to help prevent diabetic foot and toenail problems but the most important is to monitor your blood glucose levels to make sure they are in the target range and manage your diabetes.
The best way to manage your diabetes is to eat a healthy diet, exercise regularly, maintain a healthy weight, and take any medicines as prescribed by your doctor. Other ways to prevent diabetic foot problems include:
- See your doctor or podiatrist regularly for checkups and a foot exam
- Keeping your feet dry
- Practicing good diabetic foot care by washing your feet daily with warm water and mild soap, drying them thoroughly (even the skin between toes), and using a moisturizer to prevent dry skin and cracks
- Check your feet regularly for any cuts, sores, ulcers, wounds, or irritations
- Wearing comfortable shoes that fit and protect your feet by being closed-toed even in your home and avoid wearing ill-fitting shoes or tight shoes
- Wearing clean socks that are dry at all times to protect your feet and wear diabetic socks if possible
- Avoiding walking barefoot
- Not smoking
- Do not treat corns or calluses yourself and use a pumice stone to smooth any hardened skin
- Cut your toenails straight across with toenail clippers and use a nail file to smooth the nail edge to prevent ingrown nails
- Do not cut the cuticles on your toenails
Not all diabetic foot problems are avoidable but by taking these precautions you can help lower your risk.
If you have diabetes it is important to take care of your feet to prevent serious problems from occurring and to have good foot health.
If you have any questions or concerns please talk to your doctor or podiatrist.
Summary
Diabetes is a serious condition that can lead to several complications, including problems with the feet and toenails.
Treatment options vary depending on the problem but can include surgical treatments, antibiotics, antifungal medications, changes in footwear, and custom orthotics among others.
It is important to see your doctor or podiatrist regularly for checkups and to monitor diabetes.
There are also several things that can be done to help prevent diabetic foot problems, including practicing good foot care, wearing comfortable shoes, checking your feet regularly for any cuts or sores, and avoiding walking barefoot.
By taking these precautions, you can help lower your risk of developing serious complications due to diabetes.
If you have any more questions regarding foot or toenail problems due to diabetes, please talk to your doctor, podiatrist, or health care provider.
References and sources:
Mayo Clinic
WebMD
Healthline
CDC
Diabetes UK
Fact Checked and Editorial Process
Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.
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Chris is one of the Co-Founders of Diabetic.org. An entrepreneur at heart, Chris has been building and writing in consumer health for over 10 years. In addition to Diabetic.org, Chris and his Acme Health LLC Brand Team own and operate Pharmacists.org, Multivitamin.org, PregnancyResource.org, and the USA Rx Pharmacy Discount Card powered by Pharmacists.org.
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