People With Diabetes Urged to Maintain Healthy Feet, Prevent and Manage Nail Fungus

CHICAGO -- Citing the large number of people with diabetes who have nail fungus, the American Association of Diabetes Educators (AADE) announced the launch of "Take the Right Steps to Foot Care," a national education campaign that emphasizes to people with diabetes the importance of proper foot care, highlighting the impact that potentially serious complications of progressive, recurring nail fungus can have on their overall health and quality of life. The campaign is supported by an unrestricted grant from Dermik Laboratories, a prescription skin care company in Berwyn, Pa.

Approximately 17 million Americans have diabetes and it is estimated that one-third of them develop onychomycosis, the most common type of nail fungus. Individuals with diabetes are at greater risk for nail fungus, as their blood circulation is poor in the extremities, and their bodies' ability to fight infection is compromised. For these individuals, nail fungus may start as just an embarrassment, but if left untreated the condition can progress to skin or bone infections or even tissue death, causing a loss of mobility and independence.

"Lower extremity complications are a significant cause of hospitalization, disability and illness among people with diabetes," said Dr. Jane Kadohiro, president of the AADE. "We are pleased to sponsor a program that will provide people who have diabetes with the information and resources they need to confidently monitor for, prevent and self-manage such foot problems as nail fungus."

A national print and broadcast media campaign has been launched to coincide with a new informational Web page on the AADE Web site, www.diabeteseducator.org. The Web page details steps to help ensure that individuals with diabetes receive proper foot care, and outlines key risk factors, symptoms, preventive measures and treatment options associated with nail fungus.

"The best offense against nail fungus is a good defense," said John Steinberg, DPM, assistant professor, University of Texas Health Science Center. "Therefore, it is important for individuals with diabetes to inspect their feet closely each day and work with their primary care physician, diabetes educator or podiatrist to develop a program of thorough foot care."

Onychomycosis is a persistent fungal infection of the nail that affects at least 34 million Americans, most often people between the ages of 40 to 60. It occurs when dermatophyte fungi, usually Tricophyton rubrum, invade the nail bed. Although the incidence is higher in the elderly and in men, it can affect all ages and women as well. Toenail infection is four times more common than fingernail infection, probably because the moist environment in shoes promotes fungal growth.

Symptoms of nail fungus include changes in the color, texture and thickness of the nail. The nail may be easily broken, and the toenail may thicken and cause pressure, especially when shoes are worn. Persons with nail fungus may have difficulty wearing shoes or even walking, and the infection can spread to other nails and other people. Nail fungus can also impact self-esteem, as sufferers may avoid recreational activities requiring them to remove their shoes because of the appearance of their feet.

As warm weather approaches, people with diabetes may be at a greater risk of developing nail fungus because of increased exposure to specific risk factors, such as walking barefoot in areas of contamination (swimming pools, communal showers), exercise and wearing sweaty athletic socks. Individuals can take the following steps to prevent nail fungus:

* do not wear tight-fitting shoes or the same pair of shoes every day;

* wear socks that absorb moisture;

* wash and dry feet daily; and

* remove shoes and socks at every doctor visit so feet can be examined

If a person does develop nail fungus, proper diagnosis is critical to treatment. There are some physical signs that help physicians, diabetes educators or podiatrists determine whether the nail's condition is due to fungus or another problem, however clinical tests are the best methods for confirming or ruling out the presence of nail fungus. It is relatively easy for fungus to invade the nail and spread, so stopping disease progression is important at the first sign of infection. Treating nail fungus does not happen overnight, especially since nails, particularly toenails, grow slowly. A person may need to continue on a treatment regimen for an extended period of time.

In the last few years, several FDA-approved antifungal agents have become available by prescription, including oral medications and topical treatments. People should visit their doctor and find out what treatment may be appropriate for them, especially those in the growing senior population and people with diabetes, many of whom are already taking other medicines. For people in these populations who cannot or choose not to take oral medications, a topical treatment may be a feasible treatment option.

Founded in 1973, the American Association of Diabetes Educators is a multi-disciplinary professional organization dedicated to advancing quality diabetes self-management training and care, as well as the prevention of diabetes and its complications.

Dermik Laboratories specializes in prescription treatments for skin and nail conditions and is committed to educating the public about skin care and nail care.

Source: American Association of Diabetes Educators

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