Study Objectives The objective of this study is to determine the relative safety and clinical efficacy of laser treatment using the FOX Nd:YAG 1064 nm device compared to conventional therapy (topical terbinafine) in diabetics with onychomycosis of the hallux (great toe). Specifically, the study will test the hypothesis that participants randomized to the FOX Nd:YAG laser are more likely to be cured 6 months after initiating therapy compared to those randomized to conventional therapy. A secondary objective will be to determine the improvement in quality of life with laser treatment versus conventional therapy.