Have Diabetes? Take That Toenail Fungus Seriously

Before I was diagnosed with Type 2 diabetes, toenail fungus was a problem, but I did not take it seriously because over-the-counter remedies seemed to work just fine.

However, after having diabetes for a while I began to notice yellowing and thickening in the big toenails that spread to some of the other toes, too. Was Type 2 diabetes doing this to me?

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As always, I did some research. The fact is that a lot of people develop toenail fungus, or onychomycosis, but it is about twice as common in people with diabetes. Diabetic nerve damage in the feet, which may prevent a person from noticing damage to his toenails, and reduced circulation, which affects healing, are both partly responsible for this increased risk.

You probably already know how important it is to inspect your feet every day, looking for red spots, blisters, sores, or other types of irritation. These can become life threatening if they are left alone for very long.

The threat of lower-leg amputation hangs over us, and about 60% of these procedures occur in people with diabetes. There are fewer of these procedures now because of better diabetes care and education, but amputations are still performed when foot and leg sores do not heal.

What I did not know was that toenail fungus can lead to an increased risk for amputation. That means those benign-looking ugly toenails can no longer be covered up and ignored.

The first step to taking good care of your feet is going to a podiatrist, or foot doctor, regularly. You should visit him at least once a year for a foot checkup. This specialist will watch for signs of toenail fungus and inform you of the best ways to treat it.

Because you have diabetes, the treatment for toenail fungus will be a little different, and perhaps more aggressive, too. I tried to avoid those treatments by testing out some of the home remedies others swore by.

Here are just a few of the things others said worked for them: tea tree oil, Vicks VapoRub, oregano oil, lime juice, or fresh onion. Some recommended soaking your toes in one of these baths: mild bleach water, vinegar, half hydrogen peroxide and half water, and Listerine mouthwash.

However, keep in mind that every home treatment has to be done every day for months before expecting any sign of improvement, and some of these approaches could potentially be dangerous for people with diabetes.

I chose the tea tree oil and the Vicks VapoRub and tried each one for several months without any improvement at all. At last I gave in and asked my podiatrist what she thought I should do. Her choice of treatment was an oral medicine along with a prescription strength foot cream.

Before she gave me the oral medicine, the doctor ordered liver tests, and I got the test again three months later. The pill had to be taken for three months, and I used the big tube of cream until it was empty. The results were spectacular.

Clear, healthy toenail grew out slowly from the cuticle so that each time my nails were trimmed there was less fungus. Now my toenails look normal.

My experience with toenail fungus is not unusual, I have found. Trying to treat toenail fungus yourself is a difficult task. Because the infection lives under the nail, most topical remedies do not get to the actual source of onychomycosis.

Foot fungus lives on the skin and is more easily treated, although my diabetes doctor says that the over-the-counter medications are not strong enough to eradicate fungus. You need something stronger.

I think she is right, because I have not had to buy a tube of athlete’s foot medicine since I used the prescription she gave me.

If you do not have toenail fungus and want to keep it that way, here is a list of some things you can do:

• Inspect your feet every day. There is a mirror with a long swivel handle you can buy to help with this.

• Wear shoes and socks made for people with diabetes because they will not rub against and damage your toenails. Daily trauma can give toenail fungus a way in, and because of numbness you may not be aware that your toes are taking a beating.

• Make sure the podiatrist who trims your nails uses sterile equipment.

• Never borrow someone else’s clippers or share yours.

• Wear swim shoes in public showers and pools.

• Do not share socks or shoes with anyone.

If you do notice changes in your nails, your podiatrist should test some clippings to determine the cause. Most of the time the culprit is a dermatophyte fungus, but sometimes it is yeast or mold that has gotten under or on the nails.

After the doctor identifies which of these is present, he can offer prescriptions. Targeted treatment has a better chance of eradicating the infection from your nails. Whatever route your doctor chooses for you, please remember that this kind of infection needs to be taken seriously.

Onychomycosis increases your risk of secondary infection in your feet, which can lead to sores that do not heal. You do not want to go down that road, so take those ugly toenails to the podiatrist and get rid of them.

What things have you tried for your toenails? Did anything work for you? I would like to know.

Have you decided to try a low-carb diet for your diabetes? Bookmark DiabetesSelfManagement.com and tune in tomorrow to find out what you need to know to get started from nurse David Spero!

  • Linda Gertig

    Yeasts and molds are fungi.

  • Diane Fennell

    Thanks for your comment, Ms. Gertig! We have updated the piece to specify dermatophyte fungus.

    Best,
    Diane Fennell
    Web Editor

  • Michelle Carter

    Did you have pain and a little blackness on them?