From the Guidelines
Diabetics should avoid cutting their own toenails, especially if they have neuropathy, poor circulation, or vision problems, and instead have their toenails cut by a podiatrist or other healthcare professional to minimize the risk of foot complications. According to the most recent guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update) 1, proper foot care is essential to prevent foot ulcers and other complications. The guidelines recommend that people with diabetes who are at risk of foot ulceration should be educated on how to protect their feet, including not walking barefoot, not walking in socks without shoes, and not walking in thin-soled slippers, whether indoors or outdoors. Additionally, they should wash their feet daily, use emollients to moisturize dry skin, and cut toenails straight across 1. However, given the potential risks associated with toenail cutting, such as infection and ulcers, it is recommended that diabetics have their toenails cut by a healthcare professional, especially if they have any high-risk conditions.
Some key points to consider for proper foot care in diabetics include:
- Inspecting feet daily for any signs of injury or infection
- Washing feet in lukewarm water and drying thoroughly, especially between the toes
- Moisturizing dry skin, but avoiding the areas between the toes
- Wearing proper footwear that fits well and accommodates the shape of the feet
- Scheduling regular podiatry appointments for professional foot care These precautions are essential because foot complications represent a significant health risk for people with diabetes, and can lead to serious consequences such as gangrene or amputation if left untreated or poorly managed 1.
From the Research
Reasons to Avoid Cutting Toenails for Diabetics
- Diabetics are prone to foot infections and ulcers, which can be exacerbated by improper toenail cutting [(2,3,4,5)]
- Cutting toenails can lead to small cuts or wounds, providing an entry point for bacteria and increasing the risk of infection [(2,6)]
- Diabetics often have poor circulation and nerve damage, making it difficult for wounds to heal and increasing the risk of infection [(2,3,4,5)]
- Improper toenail cutting can also lead to ingrown toenails, which can become infected and cause further complications [(3,4)]
Importance of Proper Foot Care
- Diabetics should undergo regular foot examinations to identify potential problems early 2
- Proper foot care, including regular washing, drying, and moisturizing, can help prevent foot problems [(2,3,4)]
- Wearing proper footwear and using orthotics or other devices can help reduce pressure on the feet and prevent ulcers [(3,5)]
- Diabetics should seek medical attention immediately if they notice any signs of infection, such as redness, swelling, or increased pain [(2,6)]
Consequences of Improper Foot Care
- Diabetic foot ulcers can lead to amputation if left untreated or if treatment is delayed [(3,4,5)]
- Foot infections can spread to the bone or bloodstream, leading to life-threatening complications [(2,6)]
- Diabetics with foot problems are at increased risk of mortality, with a 5-year mortality rate of approximately 30% 5