In sickness and in health – Graham and Yolandi

We speak to married couple, Graham and Yolandi Chamberlain, about how diabetes works in their relationship and why they chose a cheese wheel as their wedding cake.


Graham (33) and Yolandi (36) live in Pretoria, Gauteng. Graham and Yolandi have been dating since 2016 and got married in August 2018.


Graham Chamberlain

How did your family support you once you were diagnosed?

I was diagnosed with Type 1 diabetes in October 2001, at the age of 16. My mother is a qualified nurse and took my diagnosis very serious. She cooked every meal with my illness in mind. It was a learning experience for my whole family and together as time went by, we learnt what my body required and how we would accommodate and adapt to my specific needs.

I consider myself very fortunate to have had the privilege of such an amazing and supportive family, who has been there for me day and night in this challenging journey as a Type 1 diabetic. Diabetes can have a serious impact on your emotions. Being diagnosed in my teenage years while enduring puberty must have played some role in my parents’ grey hair.

Ilze, my sister, has been practising karate with me since I was six. After my diagnosis, she always made sure that I had some sort of sugar with me in case of a hypoglycaemic incident.

Do you agree with the International Diabetes Federation Word Diabetes Day Theme “Diabetes concerns every family”?

Yes, most definitely! Diabetes is on such an incline and according to global diabetes statistics, 415 million adults have diabetes. That means 1 in every 11 adults has diabetes. Therefore, creating awareness and support groups for families who are affected by this illness is essential. I would love to get involved with such programmes which educate families on diabetes. Because without my family’s support, my diabetic journey would have been a lot more challenging.

How has Yolandi supported you?

From day one Yolandi has been by my side, supporting me in this daily and ever-changing illness. Her ability to understand my actions and reactions due to my blood glucose either being high or low is what really impresses me.

I know how difficult I can become if my blood glucose is high or low and this obviously has an influence on our relationship. But the fact that she can recognise and distinguish between me being irrational and me just being difficult and argumentative, keeps our relationship in balance.

Prior to me being on the insulin pump, I struggled a lot with hypoglycaemia in the evening or early morning hours, especially after karate. Yolandi insisted that I wake her up when my blood glucose level dropped, no matter what the time might be. She would get out of bed, fetch the closest form of glucose and would stay awake until my glucose level recovered.

Does Yolandi’s support help the management of your diabetes?

I often joke with Yolandi and tell her that she is the diabetes police, because she questions my decisions in a firm, yet caring and subtle way. Whenever I attempt an extra helping of potatoes or garlic bread, she would ask, “What is your blood glucose level and did you inject for that extra helping?” All this aids me in being more mindful of what I consume and helps me manage my blood glucose level that much better.

You recently changed to a Medtronic MiniMed 640G insulin pump and use Humalog insulin. Has this change been a positive one?

The change to my Medtronic 640G insulin pump has been a life-changing experience for me and my family. For years, I have been reluctant and very hesitant in the thought of having an insulin pump constantly attached to my body. Purely because I did not want to feel like a robot. I finally decided to follow Yolandi and my mother’s request to give this option a chance.

I really struggled to manage my blood glucose levels throughout the day. Work stress, karate training and daily challenges really got to me, which caused my HBA1C count to be at 12,7.

The 15th February this year, marked my first day of being on the insulin pump. It was not even a week later, when I started to feel and see the difference in my energy levels, my mood and overall well-being. In July, just six months later my HBA1C level dropped to 7,6. This is remarkable because for the first time in 17 years my count was below 8.

Tell us more about your hobbies – karate and skateboarding.

I have been skateboarding for the past 19 years but it’s purely just for fun. My talent, however, lies in karate. I started at the age of 6. I’m an instructor at the Griffins Karate Club, in Pretoria, which is affiliated to the South African Shotokan Karate Academy.

I have competed in four World Championships and recently was selected after competing in the trials for the World Championship in Slovakia next year. Karate is my passion and I take pride in having diabetes and competing on an international level.

Yolandi Chamberlain

When you started dating Graham and heard he had diabetes, were you scared?

Yes, of course I was scared. My knowledge then of any type of diabetes was none. In fact, all I knew was that Graham wasn’t allowed to eat any sugar. I had no idea that there was so much more to diabetes. I had to learn a lot as it is not just about sugar. All food and beverages had to be considered before consuming it.

I was scared that I would lose focus and start to panic or I would forget to take his blood glucose levels beforehand and inject the wrong quantity into him. Then I would be the one killing him and not diabetes.

As a partner, do you feel a responsibility to ensure Graham is managing his diabetes well?

No, I don’t feel responsible for it at all. Graham has been a diabetic for so long and he knows exactly what to do. I feel my responsibility is to help him when he can’t help himself. As his partner, I feel that I must know all about diabetes. Just in case he needs my help, I must know what to do.

You decided to have a cheese wheel rather than a traditional cake at your wedding. Explain the thinking behind this.

I felt it was unreasonable to have a traditional sweet cake when Graham is not allowed to eat it. After all it was his wedding as well. So, I came up with the idea and made the ‘cake-cutting’ part of the canapés at the reception.

What is your worst fear with Graham having diabetes?

I am afraid that the day will come when he loses his vision or some of his organs. I am afraid of losing him in at an early age.

How has Graham’s diabetes changed your life? 

In the beginning of our relationship, there was much to learn. Not only about food and beverages. I had to learn to have patience when Graham’s blood glucose was high and he felt irritated. I had to learn to give him some time for the insulin to take effect. I had to learn that when we go out, or go camping, it’s not as easy as packing and jumping into the car. Preparation for Graham needs to be done. We must keep his insulin cold all the time and it is essential for him to have enough Coke or any type of glucose.

But as you start knowing diabetes and your partner, it starts getting easier each day. Diabetes doesn’t have to come between people in a relationship. It made me a better person and brought me a lot closer to Graham.

Have you seen a change in Graham since he is using the pump?

From the time Graham got his insulin pump, our life has changed drastically and all for the best. He is feeling more constant and happier than before and I could see the difference in him almost immediately. I am so very grateful for the insulin pump and the change it brought to his health.

MEET OUR EDITOR


Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za


Potatoes – good for heart health

We look at the nutritional facts and health benefits of potatoes, especially for heart health, and why the Heart and Stroke Foundation has endorsed boiled potatoes with the skin on.


“You are what you eat” – this old saying is something to reflect on, especially when heart health is concerned. It is well-recognised that making informed choices about what we eat has a profound impact on our general physical and mental well-being, including the health of our cardiovascular system. What’s less well-known is the contribution that potatoes can make to a heart-friendly diet. 

South African statistics

At the outset, it’s worth reminding ourselves just how serious the problem is in our country. The sad fact is that South Africa has one of the highest rates of hypertension and strokes in the world. 

The Heart and Stroke Foundation of South Africa’s website provides these sobering statistics: 225 South Africans are killed by heart disease every day, 45% of adults in South Africa have high blood pressure, and 10 South Africans suffer a stroke every hour. 

But the good news is that 80% of heart disease and strokes can be prevented, which takes us back to the importance of a heart-healthy diet. 

Endorsement of boiled potatoes

The Heart and Stroke Foundation has endorsed boiled potatoes as a heart-healthy food, provided it’s boiled and served with its skin on. This is an important qualification because one of the characteristics of the potato is that it is so versatile; it can be cooked in many ways, and the cooking method has a huge impact on its healthiness. 

Health benefits of potatoes

One of the main reasons a potato a day keeps your heart happy is its high potassium content. A 150-gram serving of boiled potato will provide 20% of the recommended daily allowance of potassium. Potassium helps maintain a proper fluid balance, regulate blood pressure, transmit nerve impulses and support muscle function, including the heart muscle. 

Aside from its role in regulating blood pressure, and thus in reducing the risk of hypertension, potassium also blunts the effect of sodium on blood pressure. High sodium consumption—and that’s a South African fault—is a major contributor to hypertension. 

Potatoes are also rich in vitamins C and B6, copper and insoluble fibre. Insoluble fibre is another secret weapon in the fight against heart disease. It binds with blood cholesterol, so it is excreted safely, and doesn’t build up in the blood, thus descrease the risk of heart attack. 

Because potatoes are a source of fibre, they are bulkier than many other foods. This is important because a bulky meal is more satisfying than a light meal, even if they have the same calorific value. That’s because the more bulk there is in your stomach, the more stimulated the vagus nerve is. This nerve is responsible for transmitting the full feeling to the brain. And the fuller you feel for longer, the less likely you are to be overweight. And as we all know; extra weight is a major strain on the heart. 

Claire Jusling Strydom, a registered dietitian, says that the potato’s high potassium content, its fibre and its other important minerals make it an important part of a healthy, balanced diet. “Potatoes are cheap, they make you feel full and they promote a healthy body, including a healthy heart. That makes them a healthy and cost-effective alternative for other forms of refined starch,” she says. “But everything depends on how you cook them, and what else you put on the plate.”

Five ways potatoes improve heart health

  1. The potato’s fibre, potassium, vitamin C, and vitamin B6 content, coupled with its lack of cholesterol, all support heart health.
  2. Potatoes contain more potassium than any other vegetables. Potassium plays a crucial role in normal heartbeat rhythm, smooth muscle contraction, blood pressure control, and nervous system and heart function.
  3. Potatoes contain significant amounts of fibre. Fibre helps lower the total amount of cholesterol in the blood, thereby decreasing the risk of heart disease.
  4. Some evidence suggests that potatoes might help reduce inflammation and constipation. Although it is not proven that inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be a sign or atherogenic response.
  5. Potatoes contain several minerals and plant compounds that may help lower blood pressure. Low blood pressure that causes an inadequate flow of blood to the body’s organs can cause strokes, heart attacks, and kidney failure.

“The shocking statistics that can be decreased if we are mindful of our health are a testament that something needs to be done. We work towards the prevention of heart disease on the one hand and suggesting health and nutritious food options on the other, further driving conversation around the role potatoes play in heart health.” – says, Dr Bianca van der Westhuizen, Nutrition Science Manager at the Heart and Stroke Foundation South Africa. “Further to this, we have started a drive through which we are aiming to achieve a 25% Rheumatic Heart Disease reduction in those under the age of 25 years by 2025.”

About Potatoes South Africa
Potatoes South Africa is a non-profit company (NPC) that was established to serve, protect and promote the interest of all potato producers in South Africa. The vision of Potatoes South Africa is to play a leadership role in sustainable potato production in South Africa. Potatoes South Africa is an industry organisation that supports the potato producers (ware, seed potatoes and processing) within each region in South Africa to continuously perform optimally by: Continuously striving towards free market principles, Managing user-orientated research, Providing all role players with strategic industry information, Ensuring that all consumers have continuous access to quality products, Developing and expanding the local and foreign potato markets, and Investing in transformation in the industry through providing support to black potato producers to become commercial, providing support to communities to produce potatoes for food security purposes and educational initiatives.

Improve your health at work

It’s Employee Wellness Week in South Africa from 1 to 5 July. South Africans are encouraged to participate in wellness within their workplace.


How important is wellness at work?

Extremely! A physically, mentally, and emotionally well employee is a productive employee. A healthy work atmosphere also enables positive morale and job satisfaction. 

With an estimated 56% of women and 29% of men being overweight and obese in South Africa, corporate wellness should be a top priority at all organisations. Further alarming facts show that 1 in 3 men and 1 in 4 women in South Africa will develop a heart condition before the age of 60. Heart disease and strokes are the biggest non-infectious killers in our country while heart attacks and strokes are two of the major health complications which cause premature deaths in people with diabetes.

Did you know that up to 80% of these are due to our lifestyles and behaviour? Which means that 80% of premature deaths can be prevented through lifestyle changes.

Employee Wellness Week

The focus of this week is on wellness in the workplace and encouraging all personnel to follow a healthy lifestyle, even at work. Investing in employees’ health through Employee Wellness Programmes (EWP) is increasingly being recognised as a value-add for both the company and its people.

Companies are benefiting through reduced absenteeism, improved productivity and lower medical costs. Individual benefits are risk reduction in heart disease and strokes, and other occupational conditions, such as stress related illnesses, knowing your numbers and what puts you at risk.

Employees are the backbone of any organisation and if they are in top shape mentally, emotionally as well as physically, it benefits both the organisation and the employees to reach goal of productivity.

Improve your health at work

  1. Step up! Opt for the stairs instead of the elevator – it’s a great way to get in shape.
  2. Experience yoga, it helps with focus, flexibility, and posture.
  3. Stay hydrated! Drink at least eight glasses of water a day.
  4. Snack well! Choose to snack on fruit or yoghurt during your work day instead of sweets and chocolates.
  5. Laugh! Don’t allow work to become mundane. Take time to share a joke with a colleague or laugh at an email. Laughter is a great stress reliever.

For more information go to www.heartfoundation.co.za or find us on Facebook @HeartStrokeSA or on Twitter @SAHeartStroke

Early to bed, early to rise: sleep timing and your health

Paula Pienaar explains why sleep timing is important to your health, adding that the time you go to sleep and wake up plays a large role in whether you increase your risk of obesity and Type 2 diabetes.

Traditional lifestyle-related risk factors, such as overeating, poor nutritional choices and physical inactivity, have long been blamed for the alarming global increase in obesity, diabetes and cardiovascular disease. In recent years, it has become evident that sleep habits (sleep timing) also contribute significantly to one’s health risk status. In fact, did you know that the time you go to sleep and wake up plays a large role in whether you increase your risk of obesity and Type 2 diabetes?1-3

Sleep timing is crucial

Studies on how sleep timing affect health have shown that late bedtimes, combined with sleep deprivation (often due to waking up early enough for work) results in increased caloric intake in the late evening hours, as well as increased appetite for foods that are calorie-dense. In addition, later bedtimes seem to have become more frequent in the general population and is associated with an increased prevalence of Type 2 diabetes as well as poorer glucose control in diabetic patients.1,3

The circadian rhythm influences sleeping, eating, heart rate, blood pressure, body temperature, the levels of certain hormones, and the immune system.

Tick-tock our body clock: our circadian rhythms

The time you go to sleep and the time you wake up, or your sleep-wake cycle, is referred to as your circadian rhythm.

This internal body clock is a 24-hour internal timer that functions by cycling between sleepiness and alertness at regular intervals throughout the day.

The pattern of feeling energised and tired at usual times is an example of your circadian rhythm at play.

For most adults, the biggest energy dip occurs between 2:00 am and 4:00 am, when we are meant to be sleeping, and 1:00 pm and 3:00 pm, usually after lunch. These circadian dips are especially prominent in those who are sleep-deprived.

Did you know?

After midday, body temperature drops slightly which prompts the release of melatonin. Although this effect is at a smaller scale compared to nighttime, we often experience it as a ‘post-lunch’ energy dip occurring between 2pm and 4pm.

Social jet-lag

Today’s society has created an illuminated environment that alters the natural light-dark cycle needed to regulate the circadian rhythm. Big cities with 24-hour light exposure, workplaces with bright artificial lighting, and neon lights adorning places of entertainment are all examples of how we are constantly exposed to unnatural lighting during the time when our body needs to wind down.

Additionally, our lifestyle choices may also create a body clock that is out of sync with the environment. For example, our natural rhythm is affected by being awake when we are meant to be sleeping; sleeping for long periods during the day; and even having erratic meal times.

When we intend on ‘catching-up’ on sleep during weekends, or days off from work, we expose ourselves to the same health ramifications, as now we are trying to change our sleep timing once again. This mismatch in sleep time is called ‘social jet-lag’ and affects most of us at some stage in our lives, whether it is due to travel, social engagements or work demands.

Consequences of a disrupted body clock

The sleep disruption and deprivation resulting from irregular sleep times and increased night-time light exposure have shown to disrupt metabolic and hormonal processes.2,4,5

The body responds by:

  • Increasing hunger hormones, which may lead to weight gain and obesity.
  • Suppressing the release of sleep-inducing hormones, making it more difficult to fall asleep.
  • Creates an immune response, which lowers your immune status.
  • Increases stress hormones, which have shown to lead to hypertension and cardiovascular disease.
  • Disrupts insulin action, which favours fat accumulation.

The good news is that by adjusting your sleep routine to follow the environments natural light-dark cycle, you can support your body clock in restoring your health.

Managing sleep timing

The following tips have shown to help improve circadian function and sleep disruption:

  • Ensure adequate exposure to daylight: exposure to sunlight during the day and darkness at night helps to maintain a healthy sleep-wake cycle. This is especially important for people who spend most of their time indoors.
  • Stick to a healthy sleep and wake time routine: try to consistently make your way to bed when it gets dark, and wake up to natural light instead of hitting the snooze button.
  • Ensure the bedroom is dark, quiet and comfortable: cosy temperature; no television, mobile phones and bright lamps (see next tip below); and pets that wake you up should be kept out of the bedroom. The mattress and pillows should also be comfortable. It may be helpful to use blackout curtains, ear plugs, and eye shades.
  • Refrain from screen time at least an hour before going to bed: the blue light from certain televisions, mobile phones and tablet devices suppress the release of sleep-inducing melatonin. It may be useful to use blue-blocking glasses and apps to filter short-wavelength emissions from electronic devices. You can download such an app from https://justgetflux.com/ .
  • Avoid napping during the day, but if the need is very high, limit it to before 03:00 pm and for no longer than 30 minutes. You do not want to end up with a late bedtime and sleep deprivation the following day.
  • Get regular physical activity: moderate activity, such as brisk walking, has shown to help improve sleep quality. If you are a morning-type person, use that to your advantage and get natural morning light during your outdoor sessions.
  • Go camping! A weekend dose of nature’s light-dark cycle has shown to restore a disrupted circadian rhythm.

Shift workers and individuals who travel regularly across time zones are most vulnerable to circadian rhythm disruption and would benefit greatly from sleep-timing support. If having tried these tips, but you still are out of sync, or struggle with excessive daytime sleepiness, it is best to seek help from a sleep health professional.


References:

  1. Knutson, Kristen L., et al. “Association Between Sleep Timing, Obesity, Diabetes: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Cohort Study.” Sleep 40.4 (2017).
  2. Baron KG, Reid KJ, Kern AS, Zee PC. Role of sleep timing in caloric intake and BMI. Obesity (Silver Spring). 2011; 19(7): 1374–1381.
  3. Merikanto, Ilona, et al. “Associations of chronotype and sleep with cardiovascular diseases and type 2 diabetes.” Chronobiology international 30.4 (2013): 470-477.
  4. McHill, A. W., and K. P. Wright. “Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease.” Obesity Reviews 18.S1 (2017): 15-24.
  5. Sharma, Arpita, Shashank Tiwari, and Muniyandi Singaravel. “Circadian rhythm disruption: health consequences.” Biological rhythm research 47.2 (2016): 191-213.
  6. Potter, Gregory DM, et al. “Circadian rhythm and sleep disruption: causes, metabolic consequences, and countermeasures.” Endocrine reviews 37.6 (2016): 584-608.

MEET OUR EXPERT - Paula Pienaar

Paula R. Pienaar
Paula R. Pienaar (BSc (Med)(Hons) Exercise Science (Biokinetics)), MSc (Med) Exercise Science) is the scientific advisor to EOH Workplace Health and Wellness, and a PhD candidate at the University of Cape Town. Her scientific research relates to sleep health and managing daytime fatigue to improve workplace productivity and lower the risk of chronic disease. Her thesis will identify the link between sleep and cardiometabolic diseases (Type 2 diabetes and cardiovascular disease) in South African employees. She aims to design a tailored sleep and fatigue management workplace health intervention to improve employee health risk profiles and enhance work productivity. Contact her at paula.pienaar@eoh.co.za

Six steps to boost health and ban dread disease

John Hamlett, a fitness expert, shares six steps to boost health and ban dread disease.

According to the most recent South African Demographic and Health Survey, almost 70% of South African women are either overweight or obese, as are 13% of our children. More than double the global average of 5%.

While heart disease and diabetes are directly linked to being overweight or obese. There is evidence that a causal link exists between excess weight and cancers of the oesophagus, colon, rectum, liver, gall bladder, pancreas, breast, ovary, kidneys, thyroid gland, and even leukaemia.

It’s clear that South Africans need to take stock of their health, and their approach to regaining control of their weight – and what’s more, they need to take more action than signing up for a gym membership in January, then never using it.

“The slide to being overweight or being obese does not happen overnight. It’s the culmination of months and years of unhealthy eating, inactivity, and avoiding the right food and exercise choices for a variety of reasons,” says John Hamlett, a fitness expert and TomTom Athletics Club founder. “Losing the weight won’t happen overnight either – but doing so is vital if you are to reduce your risk of contracting a life-threatening disease, such as cancer or heart failure.”


Six tips and tricks to boost health and ban dread disease:

  • Limit your calorie intake. This doesn’t mean you need to stop eating. It means you need to make healthier food choices. Consult with your doctor or dietitian to find out what your daily calorie intake should be, and base your food choices on achieving that with the help of this handy online calorie counter.
  • Get out and about. One of the best ways to feel better about yourself is to get active – and you don’t have to go from zero to cardio hero to see the benefits. Track your movement with a TomTom Touch Cardioentry-level fitness tracker, which helps you monitor your daily step count, number of calories burned, as well as sleep and active time. Set yourself daily or weekly challenges, and decide on rewards before you start each challenge, to give yourself time to plan something healthy.
  • Ditch the diet drinks and choose water instead. Water hydrates the body, giving you a healthy glow, reducing wrinkles, and boosting weight loss. Drinking coffee or tea doesn’t count towards your daily recommended intake of eight glasses – you want to choose pure, unflavoured water for the best results.
  • Love the food you eat. It’s true that you’ll have to give up some types of food, but if you balance your food choices within your targeted calorie range, you can still enjoy tasty, filling meals. Veggies are low-calorie and include fibre (which makes you feel full) – but you can do so much more than just boiling them as part of a healthy eating plan. Steam them, roast them, bake them, spice them up with chilli or other fragrant spices. Healthy food certainly doesn’t have to be boring.
  • Up your game. Getting active by taking a walk around the office park at lunchtime is a great start – but you’ll see better results in your weight loss and health programme if you push yourself a little more each week. Take a jog at lunchtime instead of a walk, or use your newfound fitness as a foundation to make that gym membership worthwhile. If you’ve been tracking your progress on your TomTom fitness device, you can set yourself new goals (and rewards) to boost your activity even further.
  • Be prepared. Plan your meals in advance. Make sure you have all the required ingredients to prepare lunches for work in advance and have a good breakfast. A good breakfast will help you avoid those mid-morning nibbles, and a packed healthy lunch will reduce the temptation to eat unhealthy convenience foods during the day.

MEET OUR EXPERT - John E. Hamlett

John E. Hamlett is the Founder and Designer of John's New Lifestyle and is the coach of the TomTom Athletics Club Elite Athletes. He has been a professional athlete, teacher, electronic engineer and intelligence colonel; qualified as a specialist in nutrition and fitness (studied in Russia and the USA); was a physical training instructor in the military, qualified aerobics and swimming coach instructor, tri-athlete coach, gym instructor.

Toenails – mirrors of your health

Just as they say, ‘your eyes are the mirror of the soul’, so too are your toenails mirrors of your health – revealing information about nutritional status, general health and even an undiagnosed systemic disease.

Discolouration

The primary cause may be from trauma – either from an object dropped onto the toenail or from constant bumping inside a shoe, as suffered by runners and athletes. This discolouration is due to micro-bleeding under the nail, and will grow out with the nail over a period of months (it can take eight to 10 months for the big toenail to grow out completely). If severe bleeding occurs under the nail, the nail may detach while a new nail grows out, provided there is no damage to the nail matrix or the nail bed.

In some instances, in women who have dark skins, it may be perfectly normal for aging to bring about brown or black streaks in the toenails. These are due to changes in melanin (the natural pigment that causes skin and nail darkening).

Changes in consistency, curvature, surface texture, growth and even colour can be signs of a systemic process. For example, blue half-moons or lunulae on your toenails can indicate Wilson’s disease of the liver or silver salts deposition in argyria. In rare instances, discolouration can indicate the presence of a benign glomus tumour beneath the nail, or, even more rarely, malignant melanoma.

Extremely thick toenails (onychogryphosis)

Poor circulation in the feet affects blood supply to the nail matrix and nail bed. It is thought that the stop-start nature of poor circulation (intermittent hyperaemia) triggers the cell replication that can result in thickened toenails. Poor circulation can be present in cardiac conditions as well as in people who have high or low blood pressure, diabetes mellitus, or visible broken and/or varicose veins.

Onychocryptosis with paronychial inflammation

Onychocryptosis with paronychial inflammation

Ingrown toenails (onychocryptosis)

  • Excessive moisture can cause toenails to bend and penetrate the skin.
  • Pressure from shoes or from adjoining toes can shape or mould the toenail into the surrounding skin.
  • Growth spurts in childhood and adolescence can result in a toenail that is wider than the growing toe for a period.
  • Incorrect cutting of toenails can cause ingrown toenails.
  • Fungal infection under the toenail causes weakening of the nail plate and thus structural change in the curvature of the nail, and discolouration. People living with diabetes have an increased risk of fungal infections in the foot.
  • Trauma, such as accidentally dropping heavy objects onto the nail bed and/or the nail matrix at the source of the nail, causes a shape change in the resultant nail growth.

Footwear knowledge to prevent discoloured, thick or ingrown toenails

  • Avoid shoes that are too narrow in the front of the foot as these can restrict blood circulation to your toes.
  • Shoes that are too tight in the toe area may promote ingrown toenails.
  • Avoid shoes that have a shallow tapering toe box as these will constantly rub against the tops of your toenails. Toe muscle action is essential in preventing bunions and corns, hence why you should have enough toe room to be able to wiggle your toes inside your shoes.
  • Choose styles that do not require gripping friction from your toes, such as those that grip around the heel (either closed heel or strap), plus a strap or some form of fastening or closure across the instep of the foot.
  • Heeled shoes tilt body weight onto the ball of the foot. This can lead to toes curling inside the shoe, possibly resulting in hammer toes. Choose flats or lower heels for everyday use and reserve high heels for short one- to two-hour functions or events.

Find a podiatrist:

Podiatry Association of South Africa Toll-free number 0861 100 249

MEET OUR EXPERT - Anette Thompson

Anette Thompson
Anette Thompson (M Tech Podiatry (UJ) B Tech Podiatry (SA)) is the clinical director at Anette Thompson & Associates, Incorporated, a multi podiatrist practice in KwaZulu-Natal. Tel: 031 201 9907. They run a member service for Diabetes SA members at their Musgrave consulting rooms as a service to the community.