Severe LE bacterial infection with resultant amputation in persons with diabetes is costly both in terms of health care use and loss of productivity from morbidity, mortality, and disability. Although there are no long-term prospective studies that prove onychomycosis treatment prevents serious sequelae, common sense suggests that preserving the cutaneous integrity of the LE is useful for the compromised patient with diabetes. A recent study shows that oral agents such as terbinafine can effectively treat and cure onychomycosis and concomitant skin infection (dermatophytosis) in patients with diabetes. The cost savings from prevention of LE complications is significant, making the expense and effort needed to treat onychomycosis and tinea pedis in patients with diabetes a sound investment. LE amputation in individuals with diabetes is the primary cause of disability and death in this population. Education of such patients about the importance of foot and nail care is paramount.
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