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Diabetic Toenails: Changes To Watch Out For

Medically reviewed by Jezreel Esguerra, MD · General Practitioner

Written by Lorraine Bunag, R.N. · Updated Jan 29, 2023

    Diabetic Toenails: Changes To Watch Out For

    If you’ve been diagnosed with diabetes for a while now, you probably know of the issues that may arise as a result of increased blood sugar. Your doctor probably already told you about eyesight problems, neuropathy, non-healing wounds, and of course, diabetic foot. Many people are particularly concerned about the last one, since a severe case of diabetic foot can lead to amputation. For this reason, patients need to watch out for signs that a problem is emerging. An example of these signs is diabetic toenails. Here’s what you need to know about them. 

    What Are Diabetic Toenails?

    Diabetic toenails are not just about one condition. In fact, they point to nail changes that might trigger skin breakdown, ulceration, and infection. 

    Since diabetic toenails is a blanket term for a variety of changes, some may find it hard to detect a change that might result in a serious complication. This brings us to the question: What changes indicate diabetic toenails?

    Changes To Watch Out For

    If you have diabetes and are worried about developing diabetic toenails or a diabetic foot, consider checking for these changes daily:

    Redness and Swelling Around the Nail

    Redness and swelling can point to many things, including onychocryptosis or an ingrown toenail. You might also feel pain, but if you have decreased sensation as a result of neuropathy, you might not be able to feel it. 

    These two symptoms might also indicate paronychia, a superficial infection lateral to the nail plate. 

    It’s crucial to address an ingrown toenail and paronychia because they can progress into injury and infection. 

    Thickening, Discoloration, and Deformity 

    Other things to watch out for regarding diabetic toenails are thickening and discoloration (loss of translucency) of the nail plate. Often, these symptoms point to onychauxis, which may then lead to deformities like Ram’s Horn nail or onychogryphosis. 

    Onychogryphosis means the thickened and discolored nail has taken a hooked or curved appearance. 

    Note: Onychogryphosis usually happens because of infrequent trimming. People with diabetes are often hesitant to trim their nails fearing injury. Also, Ram’s Horn nail might make them feel embarrassed to ask for help in maintaining their toenails. 

    Separation of Nail From Nail Bed

    Finally, inspecting for diabetic toenails requires you to check for any separation of the nail from the nail bed (onycholysis). When detached, the nail no longer receives nourishment, causing it to lose its pinkish tinge. It may become opaque white, yellowish, or greenish. 

    Onycholysis may occur together with onychomycosis, a fungal infection that might also discolor, detach, and thicken the nails. 

    Note that the detachment may cause pain and injury to the skin surrounding the nail.

    Reminders in Reducing the Risk of Diabetic Toenails

    If you notice anything out of the ordinary, it’s best to keep a close eye on your toes and toenails. That way, you can easily report the changes to your doctor. The following reminders will also help:

    • Be extra cautious when your toes experience some kind of trauma. If you have neuropathy, you might not feel pain but an injury may still be present. 
    • Make it a point to reach your target sugar levels. Increased blood glucose can make you more at risk of infections. 
    • Worried about using ill-fitting shoes and proper nail trimming? It’s best to talk to your doctor about them. 


    Key Takeaways

    People with diabetes understand that it’s crucial for them to watch out for changes that may point to diabetic toenails. Not intervening when it’s already necessary may result in complications, such as injury and infection, that may lead to amputation. 
    To reduce the risk of diabetic toenails, be sure to reach your target blood sugar goals, wear shoes that fit well, trim your nails regularly (and carefully), and inspect your foot daily for changes that may be a cause for concern.

    Learn more about Diabetes Complications here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Jezreel Esguerra, MD

    General Practitioner

    Written by Lorraine Bunag, R.N. · Updated Jan 29, 2023

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