Diabetic toenails often look thick, yellow or discolored (white, brown, black), brittle, crumbly, or misshapen (curled, distorted), frequently due to poor circulation, nerve damage, or common fungal infections, making them hard to trim and prone to injury or ulcers, so regular foot checks and podiatrist visits are crucial.
Early signs of diabetes in the feet often involve nerve damage (neuropathy) or poor circulation, showing up as tingling, numbness, burning, or pain, especially at night, and slow-healing cuts or blisters, even minor ones, because high blood sugar damages nerves and vessels, leading to reduced sensation and impaired healing. Other indicators include dry, cracked skin, color/temperature changes, fungal infections (between toes, nails), and less hair growth on toes and feet, all signaling nerve issues or reduced blood flow, so regular foot checks are vital.
The first toenail change you'll notice in diabetic patients is likely to be discoloration. Most have some yellowing of the nails, though the shade and involvement can vary. Discoloring may start at the distal edge (tip) and run all the way to the root of the nail bed.
Localized itching is often caused by diabetes. It can be caused by a yeast infection, dry skin, or poor circulation. When poor circulation is the cause of itching, the itchiest areas may be the lower parts of the legs. You may be able to treat itching yourself.
Keep toenails trimmed because long or thick nails can press on neighboring toes and cause open sores. Be sure to trim toenails straight across—cutting into the corners of nail can cause ingrown toenails. Finish by using an emery board to file down any sharp edges.
Toenail Changes: Diabetes can cause toenails to become yellow, crumble, or become deformed.
Symptoms of hyperglycaemia
Avoid sugary drinks whenever possible because not only can they raise blood sugar levels, but they can also contribute many calories to the recommended daily calorie intake.
Many people with diabetes have peripheral artery disease (PAD), which reduces blood flow to the feet. Also, many people with diabetes have neuropathy, causing you to not feel your feet. Together, these problems make it easy to get ulcers and infections that may lead to amputation.
They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet. If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot.
Many people with diabetes experience changes in their toenails. Diabetic nails may look thickened, yellowish, brittle, or have an unusual shape.
Risk factors for diabetes
A DPM can examine your feet for diabetes warning signs such as redness, numbness, swelling, scaly skin, inflammation, loss of hair on the toes, and non-healing wounds or sores. If symptoms are found, the DPM will refer you to other physicians, in addition to scheduling you for regular visits.
Prediabetes Symptoms
“Some people with prediabetes may already have nerve damage, which can cause tingling or numbness in the feet and hands,” she notes. If you are at risk for prediabetes, your doctor may test your blood for sugar levels, or a blood sugar test might be part of your regular check-up.
Five early signs of diabetes include frequent urination, increased thirst and hunger, fatigue, blurry vision, and slow-healing sores or frequent infections, stemming from high blood sugar levels that affect the body's ability to use glucose for energy, leading to these common symptoms.
Never walk barefoot, use harsh chemicals or tools (like corn pads or razor blades) on corns/calluses, and don't soak feet in hot water; these actions risk injury, infection, and severe damage due to potential nerve damage (neuropathy) and poor circulation in diabetics, leading to ulcers and complications.
Fruits to avoid with diabetes
While you don't need to avoid these high glycemic fruits, you should limit or eat them in moderation: Bananas. Mangoes. Pineapple.
Examples of the worst foods for diabetics include:
Try to limit drinks with a lot of sugar, such as sweet sherries, sweet wines and liqueurs. Choose alcohol-free alternatives. Alcohol-free beers, ciders, wines, and spirits are now widely available. But be aware that these still have some free (added) sugars and carbs which will affect blood sugar levels.
Drink more water
“Water helps your kidneys filter out excess sugar through urine,” says Khan. “So, the more hydrated you are, the more urine production you'll have, which flushes out sugar in the body.” Always opt for water instead of sugary drinks, like soda and juice.
Physical symptoms: reduced activity, low energy, tiredness, decreased physical endurance, increased effort to do physical tasks, general weakness, heaviness, slowness or sluggishness, nonrestorative sleep, and sleepiness.
Unfortunately, in many cases where the toenail is thickened the result is permanent. This is due to the nail root, or matrix being damaged.
If your nail discoloration is caused by fungus, there are some treatments that you can do at home that may help. Ingredients like apple cider vinegar, vinegar, tea tree oil, and hydrogen peroxide are all anti-fungal and antibacterial ingredients that may be effective foot soaks for treating discolored toenails.
To permanently kill toenail fungus, you need professional treatment, with oral antifungal medications like terbinafine (Lamisil) being the most effective for clearing the infection, though they require months of use and liver monitoring. Prescription topical creams (e.g., Jublia, Kerydin) and medicated nail polishes (Penlac) are also options, often used with nail thinning or combined with oral meds. Laser therapy can be effective by heating the fungus but isn't a first-line treatment and lacks strong evidence for a permanent cure.