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Diabetic Foot and Toenail Care

People with diabetes can easily get wounds on their feet. Improper cutting or care of toenails and feet is the leading cause that could lead to toe finger and foot amputation.

Improper care of foot or cutting of toenails, especially in diabetes patients, is a significant factor that could result in the amputation of toe finger and foot in the future.

The proper toenail care will somewhat help prevent wounds from complications, pain, and walking problems. Proper care of ingrown toenail that caused by improper nail cutting can also help prevent the wounds.


Causes of wounds in diabetics

The cause is peripheral neuropathy, which results in the skin in the leg becomes dry and itch. This caused patients to scratch and leads to an open wound and prone to infections. Another case is when patients feel numbness in the foot, this could easily result in injuries. Before the patient acknowledges the problem, the wound could become infected and spread, making it difficult to treat. In severe cases, it could result in leg amputation.


Diabetic Foot Care Processes
  • Wash the feet with water and gentle soap every day after the shower. Avoid using a bristle brush to scrub the feet.
  • Gently dry the feet especially the toes’ skin area, with a clean and soft cloth such as towel.
  • Check your feet every day for any abnormalities such as pain, swelling, ulcers, bruises, discoloration of the skin, or blisters. Check toenails thoroughly across the sole, foot, skin between, and around the toenails. (Suggest using the mirror to look through to examine the feet). If there is any abnormality, the patient should seek medical attention.
  • Recommend wearing shoes at all times both indoor and outdoor. Wearing shoes will help protect the feet from encountering wounds. Always inspect the inside of the shoes for any foreign matter such as pebble or sand before wearing the shoes. Even a small wound or abrasion from an object could lead to injuries that are slow to recover.
  • People with diabetes should wear a proper kind of shoes with a sole made with soft material and a well-fitting size. It should not be too tight or too loose as it could cause friction and wounds.
  • Toenails should be carefully cut in a cross section pattern along the skin. If the patient has an eye problem, they should ask others to help cut the nails for them.
  • Recommend applying lotion on the foot as it can help reduces skin dryness but should avoid using it on the skin between the toes.
  • Regular leg and feet exercise at least 15 minutes a day is essential as it helps with blood circulation.
  • Do not try cutting toenails by yourself if you have thick skin or corns; recommend using a podiatrist to help cut toenails. Patients should cut their toenails every 6-8 weeks.
  • If there are wounds at the toenails, patients should receive treatment as soon as possible. 

BEFORE AFTER


Behaviors to Avoid
  • Avoid wearing pointed shoes, high heels, open shoes, no strap shoes, or mule shoes.
  • Do not wear socks that are too tight.
  • Do not use a hot water bag, heating pad to compress on the feet, or hot air blow at the feet.
  • Avoid walking barefoot, especially on a path with a high temperature. However, if it is unavoidable, it is recommended to walk carefully.
  • Avoid using corn removal cream, warts removal cream, or razor blade on the feet by yourself. Always consult with the doctor first before deciding to use these items.
  • Recommend losing or managing the weights to be within a standard criterion.
  • Avoid smoking because substances found in cigarettes will cause arteriosclerosis, which reduce the blood circulation flow to the feet.
  • Avoid wearing jewelry on the feet. 

Steps of Toenails Cutting Services
  1. Assess the conditions and feet issues of toenails and fingernails of diabetics and other patients that receive the service.
  2. Inform the patients regarding guidelines according to the treatment plan, treatment period, and treatment cost.
  3. Prepare tools for cutting services.
  4. Use 0.9%NSS solution to clean nails and feet before and after the treatment procedure.
  5. Cut nails in the cross section pattern and scrape the skin in the area with fungal infection.
  6. After finishing cutting the nails, clean the nails, feet, and sole again and check at the skin between toenails, sole, and heel to be in good condition.
  7. Apply lotion on the feet but excluding the skin between toenails.
  8. Give instructions to patients and relatives on how to care for and cut the toenails properly. 



Post-assessment after the Procedure

The patient receives proper care and nail cut and found no complications such as bleeding or wounds after the procedure. The doctor’s instruction is needed to undergo toenail care services. Any issues about foot or toenails apart from the services provided need to be informed to the doctor. So, the doctor can refer to the specialist for further treatment.


MedPark Hospital offers toenail care services for diabetics.

Every Tuesday – Saturday 8.00 a.m. – 6.00 p.m. by a specialized podiatrist with extensive experience on toenails and diabetic toenails care. The treatment is suitable for patients undergoing chemotherapy, anticoagulants, patients, or the general public with problems relating to toenails, thick skin, ingrown nails, fungal nail infections, among others.