{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:43:52Z","timestamp":1790649832340,"version":"4.1.0"},"reference-count":113,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Onychomycosis is a prevalent and clinically relevant complication among individuals with diabetes. It is associated with an elevated risk of secondary fungal and bacterial infections, foot ulceration, and, in advanced cases, amputation. Factors contributing to the increased prevalence of onychomycosis in this population include age, peripheral vascular disease, poor glycemic control, neuropathy, suboptimal foot hygiene, and nail trauma. While dermatophytes are the most common pathogens, diabetic patients are more prone to mixed infections involving Candida species with varying antifungal susceptibility profiles, necessitating accurate identification to guide therapy. Prompt diagnosis and early intervention are important to prevent complications. Systemic antifungals such as terbinafine and itraconazole are considered first-line therapies, particularly for moderate to severe onychomycosis. However, drug interactions, renal, hepatic, and metabolic comorbidities may necessitate individualized treatment plans. For patients with mild to moderate disease, or contraindications to oral therapy, topical agents such as efinaconazole or tavaborole offer viable alternatives. Adjunctive measures, including education on foot hygiene, prompt treatment of tinea pedis, and environmental sanitization, are important in preventing recurrence and reinfection. This review summarizes the epidemiology, diagnosis, and treatment considerations for onychomycosis in diabetic patients, emphasizing the need for individualized care to improve outcomes in this high-risk population.<\/jats:p>","DOI":"10.3390\/life15081285","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:30:38Z","timestamp":1755091838000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Onychomycosis in Diabetics: A Common Infection with Potentially Serious Complications"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8664-7723","authenticated-orcid":false,"given":"Aditya K.","family":"Gupta","sequence":"first","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"},{"name":"Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Liddy","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Magal","sequence":"additional","affiliation":[{"name":"Shemer Clinic, Netanya 4216000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avner","family":"Shemer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 52621, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1121-5619","authenticated-orcid":false,"given":"Elizabeth A.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ditte Marie L.","family":"Saunte","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark"},{"name":"Department of Dermatology and Allergy, Copenhagen University Hospital\u2014Herlev and Gentofte, 2900 Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-9750","authenticated-orcid":false,"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Mediprobe Research Inc., London, ON N5X 2P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.25259\/IJDVL_360_2022","article-title":"Prevalence of Onychomycosis in Patients with Diabetes Mellitus: A Cross-Sectional Study from a Tertiary Care Hospital in North India","volume":"89","author":"Agrawal","year":"2023","journal-title":"Indian J. 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