Diabetes is a whole-body condition that can affect everything from your eyes to your toes. When you have diabetes, you are more prone to foot problems, and those problems can even extend to your toenails.
Changes in your nails can be an early warning sign that something is amiss. That’s why it’s important to pay attention to your nail health if you have diabetes.
This article focuses on what it means when people with diabetes experience nail changes, especially when those changes lead to diabetes nails falling off.
How are diabetes and nail problems connected?
If you’re living with diabetes, you might be wondering why you’re suddenly experiencing nail problems.
Here’s why people with diabetes are more likely to experience changes in their nails:
Poor circulation
Diabetes can affect your blood flow, especially to your hands and feet. Without good circulation, your nail growth slows down. That also makes it harder for your nails to heal when they’re injured.
Neuropathy
Diabetic neuropathy can cause you to lose feeling in your feet. If you can’t feel pain or pressure, you may not notice an injury to your nails. Then, that little injury can become a bigger problem.
Increased susceptibility to infections
Diabetes can sometimes weaken your immune system. The higher glucose levels in your body can also lead to fungal and bacterial growth.
Spotting nail changes related to diabetes
If you have diabetes, it’s important to pay attention to your fingernails and toenails. Changes in your nails can be a sign of an underlying problem that needs attention.
Discoloration
Yellow, brown, or other unusual colors can be a sign of a fungal infection or another condition that needs treatment.
Terry’s nails, which are mostly white with a narrow pink or red band at the tip, can be associated with diabetes, too.
Thickening and deformity
Nails that are getting thicker (onychauxis) is a common issue.
Sometimes, neglected or injured toenails can develop into a “ram’s horn” shape (onychogryphosis).
Pincer nails, also called trumpet nails, curve inward and can cause pain and discomfort.
Nail separation (onycholysis)
The nail can detach from the nail bed because of an injury, infection, or other reasons. Any separation should be monitored, as it can be an entry point for infection.
Beau’s lines
Grooves that run across the nails can be a sign that nail growth has been interrupted. This can happen because of poorly managed diabetes, illness, or some medications.
Specific nail conditions and diabetes
People with diabetes are at higher risk for certain nail conditions.
Onychomycosis (Fungal Nail Infection)
If you have diabetes, you may be more likely to develop fungal nail infections because diabetes can weaken your immune system and affect your circulation, but it’s also important to differentiate this condition from gout toenail fungus. These infections can cause nails to thicken, crumble, and change color, and they can be hard to treat, but some people seek alternative methods like a Japanese toenail fungus cure recipe.
Paronychia
Paronychia is an infection of the skin around the nail, often caused by bacteria or fungi. People with diabetes are more likely to develop paronychia because diabetes can affect how well the body heals.
Onychocryptosis (Ingrown Toenail)
Ingrown toenails can happen when you cut your toenails the wrong way, wear shoes that don’t fit well, or stub your toe. If you have diabetes, you may have a higher risk of problems with ingrown toenails because of nerve damage and poor circulation.
Subungual Hematoma and Black Toenails
Bleeding under the nail can cause a dark spot or a black toenail. If you have diabetes, you may not notice a subungual hematoma right away because of nerve damage. While less common, it is important to rule out other causes of dark spots on your nails, such as melanoma, with your doctor.
When nails fall off: Causes and concerns
If you have diabetes and your nails are falling off, here are some possible causes:
- Advanced onychomycosis: A severe fungal infection can weaken your nail and cause it to detach.
- Trauma: Even minor injuries can cause the nail to come off. This is especially true if you have neuropathy and can’t feel the injury.
- Severe infections: Bacterial infections can damage the nail matrix, which can cause the nail to fall off.
- Poor circulation: Without proper blood flow, your nails can become brittle and eventually detach.
If you lose a nail, it’s important to seek medical attention right away. The exposed nail bed is very vulnerable to infection, which can lead to complications like ulcers.
Frequently Asked Questions
What is the first stage of diabetic toenails?
The early stages of diabetic toenail issues often involve subtle changes. You might notice thickening, discoloration (yellowing or browning), or ridges forming on the nail. These changes can indicate a fungal infection or poor circulation, both common in people with diabetes. Early detection and treatment are key to preventing more serious problems.
Should I go to the ER if my toenail is falling off?
If your toenail is falling off, especially if you have diabetes, it’s generally best to see a podiatrist or your primary care physician promptly. However, if you experience severe pain, excessive bleeding, signs of infection (redness, pus, fever), or have a significantly compromised immune system, then heading to the ER might be the most appropriate course of action.
Can type 2 diabetes be reversed?
While there’s no “cure” for type 2 diabetes, it can often be put into remission through significant lifestyle changes, such as weight loss, a healthy diet, and regular exercise. Remission means your blood sugar levels are normal without medication, but ongoing monitoring is still essential.
What do B12 deficiency nails look like?
B12 deficiency can manifest in various nail changes, including brittleness, darkening of the nails (hyperpigmentation), and longitudinal dark streaks. In severe cases, nails may become spoon-shaped (koilonychia) or separate from the nail bed (onycholysis).
Will urgent care remove a nail?
Urgent care centers can often remove a toenail, especially if it’s partially detached or infected. However, it depends on the specific urgent care facility and the provider’s expertise. It’s always a good idea to call ahead to confirm they offer nail removal services and are comfortable treating patients with diabetes.
Wrapping Up
If you have diabetes, examine your feet and nails regularly for any changes. It’s also important to have a podiatrist examine your feet and nails regularly.
When you trim your nails, cut them straight across to keep them from becoming ingrown. Don’t cut your cuticles. Keep your feet and nails clean and dry.
Wear shoes that fit well and give your feet plenty of support. Avoid shoes that are too tight, since they can hurt your feet and nails.
If you notice any signs of infection, inflammation, or your nails separating from your nailbeds, seek medical attention right away. Follow your doctor’s treatment plan for your feet and any wounds.
If you have diabetes, learn as much as you can about foot and nail care, including ICD 9 nail fungus coding, diagnosis & treatment. Catching problems early can help you avoid serious complications.