Why cant you cut diabetic toenails

Published on March 7, 2013 by WCEI Content Team

You are getting ready to trim your diabetic patients toenails. What exactly does that all involve? Well, first you need the proper tools for diabetic toenails. A set of toenail nippers, nail file, and orange stick are typically used. Always follow your facility or healthcare’s settings policy for infection control. Single use disposable equipment is favorable.

You have gathered your equipment to trim the patients diabetic toenails, now what? Nails are easiest to trim after a bath or soak for 10 minutes to soften nails. The soaking of diabetics feet should only be done by a healthcare professional. You can clean under the patients toenail with an orange stick (wearing gloves), wiping on a clean washcloth in between each toe during soaking. .

After soaking and washing of the feet are completed, dry the patients feet completely. Wash your hands and put on gloves to trim the toenails. Use your dominant hand to hold the nipper. Start with the small toe and work your way medial toward the great toe. Squeeze the nipper to make small nips to cut along the curve of the toenail. Be careful not to cut the skin. Use your index finger to block any flying nail fragments. Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail. Never use two hands on the nipper. The nail is trimmed in small clips in a systematic manner. The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed. The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges. When filing diabetic toenails always use long strokes in one direction, avoid using a back and forth sawing motion.

When all toes have been trimmed and filed, remove your gloves and wash your hands. Apply clean gloves and apply lotion to the top of the foot and to the soles of the feet, rubbing lotion in well, and wipe excess lotion off with a towel. Put the patient’s socks and shoes back on as needed. Wash your hands and smile, you are done!

For your patients who are trimming their own diabetic toenails at home teach them the following simple instructions: Be sure you have good lighting. Trim toenails after bathing, dry feet well, especially in between the toes. Start with the little toe and work your way into the great toe. Use small cuts, never cut the toenail across all at once. Cut straight across and use a nail file to smooth edges. Apply lotion to the bottom and tops of the feet, never in between the toes. For patients with thickened toenails or yellowed toenails, recommend a foot care specialist like a podiatrist cut their toenails.

Foot complications are very prevalent among people with diabetes. How common? The American Diabetes Association estimates that at least 20 percent of all diabetic-related doctor visits are spurred by foot concerns! Diabetes can cause nerve damage (neuropathy) and vascular damage, reducing your sensation. You may not even feel any injuries on your feet! Although extreme, it isn’t an overstatement that a minor foot injury on a diabetic person could become life-threatening.

How many stories have you heard about a diabetic individual requiring a foot amputation because of a wound that got infected and would not heal? This 2017 systemic review of 19 studies verifies that up to 75% of all lower extremity amputations are performed on someone with diabetes! A lower extremity amputation (LEA) is no laughing matter; LEA could be anything from your little toe to both of your legs. It is vital that you take optimal care of your feet to lower your risks. Luckily, when it comes to prevention, two of the main factors are easy: toenails and pedicures.

There is a common saying that diabetic individuals cannot trim their toenails. Some people would argue that it is a myth and that diabetic people can cut their toenails themselves. However, the real issue isn’t a matter of can or cannot, but whether or not you should. You might ask, why shouldn’t you cut your nails? Because if done incorrectly you could injure yourself! Furthermore, if you have diabetic neuropathy, it is recommended that you never cut your nails.

Many people like to pamper themselves with a pedicure at a salon. For your safety, you need to be extra wary of the salon’s cleanliness standards, sanitation practices, and the skill and attentiveness of the technicians. If a technician is too rough or cuts you, you drastically increase your already raised risk of infection. If you have sensory issues in your feet you will need to specify that they only use warm water for the pedicure as the hot water may unintentionally scald your skin. A pedicure isn’t a treat if the technician hurts you. Instead of taking a risk with a regular nail salon, you should consider going to a medical spa instead.

Receiving your pedicure from a medical spa is the best alternative to a regular nail salon! Since it is a medical spa, they are required to meet the Occupational Safety and Health Administration (OSHA) highest standards for sanitation and maintaining a clean environment to prevent the spreading of diseases, germs, bacteria, and fungus; you are guaranteed to receive a safe and hygienic pedicure. Technicians at a medical spa are trained especially for helping individuals with precise medical needs.

The final concern with pedicures is so important that it needs to be addressed separately: how your toenails are cut and shaped. A regular nail salon will cut off all white growth from your toenails, regardless of the shape and length of your remaining nail. A medical spa will inspect your toenails to determine the best way to cut them. While you should never curve the corners on your nail, some professionals recommend filing the corners just enough to blunt any sharp edges. Additionally, trimming the nail too low encourages ingrown nails to develop.

Ingrown toenails are serious when combined with diabetes. If you are not checking your feet daily and have neuropathy, then you may miss the early signs of ingrown nail and infection. Always treat any nail infection right away. Leaving an infection unchecked may result in the loss of your toenail or even your toe! It is not unknown for someone with poorly managed diabetes to ignore their ingrown toenail and subsequent infection, only to require a lower extremity amputation. There is no good reason to undergo easily preventable surgery!

Regular visits with your podiatrist ensure that you are maintaining healthy foot care habits. Additionally, your podiatrist is much more likely to catch any potential issues early on. Always voice any concerns or questions you may have.

Corona Foot and Ankle proudly offers preventative advice to help you lead a healthier lifestyle, including taking care of all your diabetic foot and ankle needs. We provide medical nail restoration services for damaged toenails and medical spa pedicures. You can schedule an appointment HERE.

When you’re living with diabetes, what you can’t feel can still hurt you. This is especially true when it comes to your feet and the nerve damage you may experience. If you’ve just learned you have type 2 diabetes, you should arrange to meet with a podiatrist and talk about the importance of foot care, say foot experts Erika M. Schwartz, DPM, a spokesperson for the American Podiatric Medical Association and David G. Armstrong, DPM, a podiatric surgeon and professor of surgery at the University of Southern California Keck School of Medicine in Los Angeles.

Here, these foot doctors help you sidestep the foot pain complications of diabetes by answering your most common questions on diabetic foot care, from how to prevent nerve damage to why you should let someone else trim your toenails.

Q. When it comes to foot care, what is the first thing someone just diagnosed with diabetes should know?
Besides building a relationship with a podiatrist, a person with diabetes should know that most ulcerations and amputations are preventable, but proper foot care is essential. (Learn how diabetic foot ulcers start.)

Q. What is actually happening when you lose sensation in your feet?
Neuropathy describes the loss of sensation that arises from nerve damage. Over time, diabetes leads to what’s called a “loss of protective sensation,” or LOPS and because it occurs so slowly, many people don’t notice it. According to the National Institute of Neurological Disorders and Stroke, about 60 to 70 percent of people with diabetes have some form of neuropathy, which can occur in other organ systems, not just the feet. (Here are the best shoes for neuropathy.)

Q. How can I protect myself from nerve damage?
Neuropathies are the result of several factors, the largest being exposure to high blood glucose levels. Keeping blood sugar levels low is the best protection against nerve damage in people with diabetes. “There is some compelling emerging evidence that controlling high lipid levels may reduce the progression of neuropathy, too,” says Dr. Armstrong.

Q. Do feet need to be examined every day?
Examining your feet should be as regular a habit as combing your hair or brushing your teeth. Dr. Armstrong recommends replacing your bathroom scale with a mirrored one. Red flags for foot problems include any swelling or redness, including new areas of discoloration and ingrown diabetic toenails. Any break in the skin is reason to contact your podiatrist immediately.

Q. Why can’t you cut diabetic toenails?
If you have neuropathy or symptoms of vascular disease, you should leave clipping your diabetic toenails to your podiatrist. If you are cutting your own toenails, cut straight across the top of the toenail, leaving part of the whiter nail plate, advises Dr. Schwartz who adds, “If you are unable to feel a cut, or don’t have the blood supply required to heal a cut, you likely shouldn’t be cutting your own toenails.” Read what this woman has to say about living with diabetic foot problems.

Diabetic foot care tips

• Use caution when shoe shopping—particularly in warmer weather. Neuropathy requires more protective footwear than a flip flop or sandal. Patients with nerve damage should avoid wearing sandals with straps that weave between the toes, or those that place extra pressure against the foot. (Experts recommend these sandals for diabetic women.)
• Know the dangers of going barefoot. If you’ve lost protective sensation in your feet you’re better off keeping them in shoes—even when you’re indoors. “Unfortunately,” Dr. Armstrong says, “up to 85 percent of steps are taken in and around the home—and most of those are taken barefoot.” Keep doctor-approved slippers or shoes in several places throughout your home. (Here are the best diabetic shoes for women.)
• Work with your endocrinologist to regulate your blood glucose levels. Checking your blood sugar levels at home as instructed will help you to make better choices throughout the day. (Here’s how to maintain healthy blood sugar levels.)
• Before you slip your foot into a shoe, check inside for foreign objects. It is a scary reality, but more than a few patients have needed to undergo an amputation brought on by ulcerations from items inside footwear. (Here’s what you need to know about diabetic blisters.)
• Slip on some white socks. An open sore on the foot may be easier to spot when you see drainage on the sock, suggests Dr. Schwartz.

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Originally Published: October 25, 2010