What to know about nail fungus in people with diabetes

Fungal nail infection may make a nail yellow, white or brown, thicker, brittle or partly detached. Similar changes can come from trauma, psoriasis or other conditions, so a clinician may examine the nail and sometimes test a sample before choosing treatment. Diabetes may reduce sensation or slow healing in the feet, meaning a small cut from trimming can go unnoticed.

Check your feet and nails regularly, including the spaces between the toes. Wash and dry carefully, wear well-fitting breathable shoes and change socks when damp. Cut nails straight across without digging into the corners, and do not cut or scrape thickened nail aggressively. Have a clinician review treatment options, interactions with your medicines and whether liver or kidney checks are needed.

Contact a clinician promptly for a new wound, blister, drainage, spreading redness, warmth, swelling, increasing pain or a dark nail change. Seek urgent help if redness spreads quickly, fever develops or the foot becomes pale, blue or cold. Reduced sensation can make a painless injury clinically important, so do not wait for discomfort.

How will you confirm the nail problem? Which treatment fits my diabetes medicines and health history? How should I trim the nail, and should a podiatry or foot-care review be arranged?