It's the same reason no one slices their foot open when they walk on a sandy beach. DE makes small incisions in the exoskeleton by abrasion. Once the insides of the worm are exposed they become desiccated and die. Its the drying out that kills them. It's not slicing and dicing like some kind of food processor... Try this, mix a tbsp with just enough water to form a paste and use it as a facial mask. Wait for it to dry and then wash off. Yes, it's a mild exfoliant, but it's not going to cut you open.
If you're really toxic or are taking other things at the same time you should start off slow, like 1/2 tsp a day and work up from there. One tablespoon a day is a standard dose, but during a cleanse I may take up to 3 tbsp a day. I took it daily for about 8 months and now only use it as maintainence a few times a week or whenever I don't feel well.