Diabetes and toenail cutting

[RoadRunner44]

Why do some people refuse to cut your toenails if your a diabetic?

[sandybrown]

If they accidently cut any part of the skin, if it get infected then there will be complication!!!

This is the main reason it is a problem in UK, my aunt experienced it.

[ramana42 Volunteer]

A diabetic can cut toenails,but very carefully so as not cut the underlying skin.The cut should not be arc shaped but in a straight line.It is supposed to reduce injuries by stubbing the toes.Another important point to be noted is to be wary of ingrown nails,which may lead to severe complications.

[RoadRunner44 in reply to ramana42]

Thanks for replying so soon.

[sandybrown in reply to RoadRunner44]

Do you check your toes, feet and eyes on a regular basis?

[RoadRunner44 in reply to sandybrown]

I haven't been told to do this. What should I look for?

[sandybrown in reply to RoadRunner44]

If one is diabetic and is under the care of a health care professional then there is regular check, once a year or when it is necessary, eyes, foot and blood test.!!!!

[RoadRunner44 in reply to sandybrown]

Thanks for your reply, but I'm still in the dark about what I should be looking for with my feet.

[sandybrown in reply to RoadRunner44]

If you are in India, please go and see a specialist!

[Activity2004 Administrator in reply to sandybrown]

sandybrown ,

I will be in touch in a few minutes. It's okay.

[Activity2004 Administrator in reply to sandybrown]

Sent the message now. Please check.

[RoadRunner44 in reply to sandybrown]

I'm sorry, but I don't understand your response.

[Activity2004 Administrator in reply to RoadRunner44]

RoadRunner44 ,

sandybrown was thinking that you were living in India and thought you could see a Specialist who is also in India. No one meant to confuse anyone.😀👍

[RoadRunner44 in reply to Activity2004]

Why did he think I lived in India? Very strange.

[Activity2004 Administrator in reply to RoadRunner44]

A lot of members of the group are from India—. Diabetes India ( DI).

[RoadRunner44 in reply to Activity2004]

I dont think one should assume this, or from being from any other country for that matter. Thanks for the information anyway.

[Activity2004 Administrator in reply to RoadRunner44]

For issues with eyes, you can sometimes get Diabetic Retinopathy. If this happens, you may be sent to a Retina Specialist.

[RoadRunner44 in reply to Activity2004]

Thanks for replying to my question. I'm beginning to add to my knowledge of diabetes.

[Activity2004 Administrator in reply to RoadRunner44]

You're welcome! My pleasure!

I sent you a quick note. Did you see it?

[RoadRunner44 in reply to Activity2004]

I did and appreciate it.. many thanks.

[Activity2004 Administrator in reply to RoadRunner44]

You’re welcome!😀👍

Anytime you want to ask anything, please do!😀👍

[sandybrown]

A lot of activities !

I spent one month giving day care in a hospital ward (room) to a relative who had a stomach operation. When I was going in and out of the ward I saw a lot of people and most of them were discussing their toe (infection complication) and foot (infection)problems.

In UK, NHS, offer once a year check up for foot, eye and blood test to keep T2 under control.

It does not matter where we live, it is imperative we understand our health issues and get proper health care.

I am sorry for any inconvenience caused. From now on I will be very careful to what extent I get involved with my response, I strongly believe in passing on my experience for cholesterol and type2.!

[gangadharan_nair]

Slight wound in the toenail may cause complications. If you go to the hospital, you may be infected by a superbug (drug-resistant bacteria) such as staphylococcus aureas, pseudomonas aerunginosa etc. The treatment will be prolonged causing financial burden.

Links:-

en.wikipedia.org/wiki/Diabe...

medlineplus.gov/ency/patien...

[sandybrown in reply to gangadharan_nair]

Thank you. You made my day by bringing home the important point of complication.

[RoadRunner44 in reply to sandybrown]

Thank you so much. Your reply to my question has been answered in a simple and understandable way. When you are confronted like myself, with the possibility of becoming diabetic the response is to find answers to the many questions that come to mind. Hopefully by becoming a member of this group (although a new one) I will grow in confidence and knowledge. Thank you again.

CHRYS

[sandybrown]

In UK, NHS, GP practice, can do fasting blood glucose or a 90 day HbA1c blood test.

A GP practice diabetic nurse can check the feet with tuning fork for vibration check, ultra sound device and a another device to check for sensitivity.

There are courses one can attend and have discussion with other people.

A life style change, watching out for what goes into the mouth, free and hidden sugar together with regular exercise can help to control type 2 to delay medication or no medication at all. A GP practice can do a referral to a GYM as well.

[Activity2004 Administrator in reply to sandybrown]

The classes that the doctor can send a patient to is the DAFNE program for more Diabetes education. Also, the DRWF has Diabetes Days for everyone to learn more about Diabetes and get more information.😀👍 Hope this helps.😀👍

[RoadRunner44]

Many thanks yet again.

[rnpath]

simple if you injure yourself in the toe, it is difficult to heal and may indeed be the starting point of infection if due care is not taken

[RoadRunner44 in reply to rnpath]

Hello, and thanks for the advice. Do you know if its just injured toes that could cause infection? It's just that a number of health care workers refuse to cut toenails and it sounds like there is a link between toes and diabetes. I am very ignorant at the moment and probably ask silly questions but all these little questions have to be answered to build on my knowledge.

[Activity2004 Administrator in reply to RoadRunner44]

No question is ‘silly’. Anytime you have a question about anything, please let us know what you want to know information about and we will try to help.😀👍

[rnpath]

the healthcare workers have been advised to be careful because of the litigation based society we live in case of complications arising out of the procedure.

[RoadRunner44 in reply to rnpath]

Thank you, but how or does one have this service? Does the NHS offer a service to diabetics?

[Hidden]

The very first thing to note is that as a diabetic, your feet are the most vulnerable because they are so far away from the heart and that diabetes and poor blood sugar levels will begin to destroy the nerves in the feet, causing numbness which will also include restrictions of blood flow to the feet due to the excessive BS levels damaging veins and arteries and the circulation, especially in the foot. That is one of the reasons that diabetics can develop ulcers in the foot, that will persist, be very difficult or even impossible to control which may well lead to amputation. That is also the same for poor circulation where toes can actually die due to inadequate blood flow. Diabetics are also advised never to go barefoot because if they get a cut or injury and suffer with poor circulation, the damage might take ages to repair or even go on to develop an ulcer. My father in law was diagnosed with diabetes after a heart attack and had probably been diabetic for years before that. After two years he developed ulcers on one foot that never healed which resulted in his having to have a "boot" made by the hospital to accommodate the bandage.

So in short, some people are reticent to cut a diabetics toe nails for fear of damaging the skin which could develop into an ulcer if it does not heal. A trained chiropodist will have the skills to do this for you - I am also type 2 diabetic and have my feet "done" by a chiropodist.

Now then, due to all these high risk complications, every diabetic should be checked by their doctors surgery diabetic nurse who call the process the HbA1c test, administered every six months which requires a urine test, a blood test. Once these results are available, you should be recalled for a meeting with the nurse to discuss your tests and to give you the final test, a skin sensation test of the feet. They will use a fine wire or plastic fibre to touch the bare foot in different areas and will ask you to close your eyes and indicate when you can feel the sensation of the gentle touches. This will indicate whether you have and the extent of any deterioration in the nerves of the foot. There is very little that can be done to rectify this loss and why they describe the disease as a “Progressive” since it will only get worse unless the patient can control their BS level through diet and exercise which is a complete subject in itself! The other information will be a very accurate reading of your BS levels over the last six months plus liver and kidney functions, cholesterol levels and vitamin B and Iron levels. Urine will disclose whether there is any sugar in the water. I am sure I will have missed things but essentially that is what the nurse will be looking for.

Every diabetic should receive at least a yearly test and if possible two a year are preferable.

Since the eyes are also a very vulnerable area of concern, they should also be offered an eye screening test once a year, where a specialist photographer will take images of the eye, looking for any changes, including small bleeds in the back of the eye that can lead to blindness. Cateracts and other changes to the eyes are all checked. A basic eye test with the usual ABC board will also be undertaken. The tests are sent off to a specialist to review the images and if there is "anything" to worry about, you would be called to attend a hospital appointment where your eyes would be inspected by a specialist.

Comfortable and sensible shoes that do not pinch and will not cause blisters, clean dry socks or whatever, washed and rinsed to ensure the complete removal of all traces of washing powder. Keeping the feet warm and protected from damage are all sensible areas to have a look at. Cleanliness is an obvious are as is dampness, so afetr washing/bathing, feet should be gently but thoroughly dried before re dressing or whatever. Something like an E45 cream is also good to keep the skin healthy and not dry out. The rubbing of the cream into the foot is also valuable since it will encourage circulation.

I apologise for the long reply but did not want to miss anything out and hope it answers your questions and concerns and as they say - "The rest is up to you"

[Activity2004 Administrator in reply to Hidden]

Thank you for the great information with foot care. Have you read the free leaflet dealing with foot care and Diabetes? Go to: drwf.org.uk/understanding-d...

I hope this helps!😀👍

[Hidden in reply to Activity2004]

No I had not seen this and very informative - thank you

[Activity2004 Administrator in reply to Hidden]

You’re welcome! Sorry for the delay in the reply. Just got done with dinner now.😀👍

[sandybrown in reply to Hidden]

Please explain this line:

" Urine will disclose whether there is any sugar in the water"

Regular HbA1c ,foot check and eye check, a machine that look into the back of the eye to take a image and the image is analysed on a computer!, are important.

We all have to watch out for any cut to our body as infection can bring in complication.

[Hidden in reply to sandybrown]

Pretty straight forward ones urine is tested to check if there is any sugar present in the water - the other items I am not sure what you have a problem with - sorry

[ThreeSmiles in reply to Hidden]

Great post ticker 👍.

Only thing I can comment on is that at my Hospital the person who performs the eye test states the result of the test/photos there and then - so no worrying time luckily! 😁👍

Angus

[Hidden in reply to ThreeSmiles]

Hi Angus, I had believed that to be the case since all the equipment and expertise was at the fingertips of the technician. I have only ever been tested at the doctors surgery and is why there is always a delay - having said that, the letter comes through within five days so not too much worry time. Nice to hear from you

[ThreeSmiles in reply to Hidden]

Thank you and you 👍

[sandybrown in reply to ThreeSmiles]

In UK, the machine operator take the photo. A week later a letter arrives if it is good, OK or bad.

An appropriate action needs to be taken.

[ThreeSmiles in reply to sandybrown]

Hi Sandy

We must be lucky in Derby the optometrist taking the photo tells you the result there and then right after the photo. A letter arrives later on confirming that in writing - this also goes to your GP.

Angus

[sandybrown in reply to ThreeSmiles]

Every Year I get a letter to make appointment for eye screening , blood testing and foot check from the GP practice nurse. All done by NHS staff.

I am sure most of NHS do similar screening. I do not go for high street eye screening.

"Getting your results Within 6 weeks, both you and your GP should receive a letter letting you know your results.

We can't provide results immediately as the photographs need to be studied by a number of different healthcare professionals, including someone who is trained in identifying and grading retinopathy.

What the results mean The results letter will inform you of the level of retinopathy and maculopathy that has been found at the back of your eye.

The retinopathy grade will tell you if the eye has generally been affected by diabetes and the maculopathy grade will say if it is affecting the most important part of the eye – the macula.

Retinopathy R0: Very little risk of sight –threatening diabetic retinopathy. Do not need treatment at this time and background retinopathy does not affect your sight R1: Back ground retinopathy. Small changes to the blood vessels in the retina at the back of the eye.

R2: Pre-proliferative retinopathy: changes to the retina that could result in long-term problems with your sight.

R3: Sight threatening retinopathy: Serious changes to the blood vessels at the back of the eye that need treatment. This may involve laser treatment or an injection into the eye.

Maculopathy M0: No changes that affect the macula.

M1: Changes to the macula which needs further checks more often than 12 months Other information provided in the letter may include:

Referral to ophthalmology: The photographs have shown that you have some abnormalities in the retina that have been assessed and considered that you may need some treatment. Not related to diabetes:

Further assessment is required by an eye specialist, or you have cataracts and have requested to see an eye specialist regarding this. Photographs not clear:

Referral to hospital eye department to see an eye specialist who will use different equipment to get a clearer view of the back of the eye Assessment clinic:

Your results letter will say if changes unrelated to diabetes have been found that need further assessment, or you have cataracts that you have requested to see a specialist about. VOPDR (digital surveillance): If maculopathy is found then this will need to be seen by a specialist for further tests. If sight-threatening retinopathy is found you will be referred to a specialist to discuss treatment options."

[RoadRunner44 in reply to sandybrown]

Gosh, your post was so full of information. Thanks.

[ThreeSmiles in reply to sandybrown]

I have had that eye test for years and I always get the result there and then despite what is quoted. Ah well different Health areas do differ unfortunately!

[sandybrown in reply to ThreeSmiles]

Well, whether you like it or not, the information given is from Derby, NHS, site!!

There is similar information on other NHS sites as well.

[ThreeSmiles in reply to sandybrown]

Lol I didn’t say you were wrong. I am just stating MY experience from years of diabetic eye screening. I don’t see why you are getting at me to be honest?

[sandybrown in reply to ThreeSmiles]

Please note that I am not getting at you!.

Ever since I was told by GP diabetic nurse that I am diabetic, I have done a lot of research to go on to life style change to avoid medication. Because I am on the diabetic register I get to do once a year tests.

So far my life style change has helped me. Only time will tell.

My research on cholesterol and blood glucose and help with doctor's discussion has been vey useful to write here.

I do not agree with NHS food plate, I am told by the diabetic nurse what I should eat!!, I disagree every time. NHS, HCP have to follow NHS guide lines.

[ThreeSmiles in reply to sandybrown]

Aha that’s good from the not getting at me viewpoint 😁😁👍 thank you!

It’s not good re your experience ☹️. It’s a shame when you don’t agree with nurse 👎🏻. Fortunately I have never really been preached at what to eat. I used to get given the little books which I tended to ignore - naughty me! BUT then I got sent on the xPert diabetes course run by experience people going around the country. It gave a completely new view on what not eat and what to eat. The new teaching completely goes against nearly everything we’ve been told for 30 years. They know this but this is the way forward! It’s a 15 hour course spread over 6 weeks. I was totally sceptical at the start but in the end thought it was brilliant maybe with the exception of dwelling to much on the biology front!

You get given a great book as well called

“X-PERT Diabetes Prevention & Management Handbook version 13.1” .

This book is gone through in detail. Of course everything is free 👍 because it’s NHS. 😁👍

Angus

[Activity2004 Administrator]

If your blood sugar is high, some people may spill sugar in the urine.

[HOBIEONE]

I have been T1 since a team WON the world cup & have always cut my own nails.