Ingrid Kruse, DPM
TCOYD Newsletter, Vol. 26, 2008

Atask as mundane as cutting your toenails can pose a problem for some people, whether or not they have diabetes. If you have visual impairment (from retinopathy or another cause); or disabling arthritis in your hips or knees preventing you from reaching your toes; or poor circulation; or simply a midsection large enough to interfere with your ability to reach your toes, cutting your nails can be a challenge! Also, if you have some nerve damage from diabetes (peripheral neuropathy), and your feet are numb as a result of that, then it is really not a good idea to cut your own nails due to the chance of unknowingly injuring yourself. In all these above scenarios, it is much safer to seek professional help.

That being said, most people with diabetes are perfectly able to cut their own nails keeping a few simple rules in mind:
• Cutting your nails straight across is generally the best advice, however, rounding the edges a bit is ok. Follow the shape of your toe; some toes have very round tips.
• Don’t let your toenails get too long; they can dig into a neighboring toe or cause problems with enclosed shoes by jamming into the front of the shoe and injuring your toes in the process. Also, long toenails get caught on socks, towels or clothing and rip or tear, which can lead to bleeding wounds and infections.
• Toenails grow slower than fingernails and also grow slower as we age. Generally, cutting them every 6-8 weeks is fine.

If you have fungus nails, trimming them yourself can be quite a challenge unless you use hedge clippers. This not recommended! There are many ways to deal with fungus nails, including topical antifungals, oral medications, or burring them down with a grinder to make them more manageable. You should discuss the different options with your podiatrist or dermatologist.

One question I am asked a lot is: “Is it ok to have a pedicure?” My answer to this is: yes, with the caveat that clean instruments are used (sterilized between clients) and you let them know you have diabetes. One thing I would advise against is letting them cut your cuticles. It is really unnecessary and most injuries occur while cutting cuticles rather than nails. I have been cut several times and now ask the beautician to just gently push back the cuticles or leave them alone.

What about ingrown toenails? If there is any sign of infection, such as redness, swelling or drainage, you should see your podiatrist as soon as possible. Do not attempt to deal with this yourself.We call this “bathroom surgery” and it usually makes it worse!

Remember: If you can’t see, feel or reach your toes, leave it to someone else!

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Related Resource: Be Sweet To Your Feet, Episode 104