July 5, 2002
Other Illnesses
Question from North Wales, Great Britain:
Our eight and a half year old daughter, who has had type 1 diabetes since the age of 16 months, is usually well controlled and has no overall areas of concern. However,she has extremely brittle toe nails on both feet, causing the occasional ingrown toe nail.The nails shear off from side to side but in the opposite way one would expect. For instance, if you stubbed your toe, you would expect that the nail would layer going backward towards the knuckle, but her’s layer forwards towards the edge of the nail!
At first, I thought I must be cutting them incorrectly, but all the medical advice I got said I wasn’t. We see a chiropodist every month, and none of the ones we have seen have come across this before. We had tests for fungal infections too but there is no infection.
She has a well-balanced diet with a pint of milk a day and lots of fresh fruit and vegetables, as well as cheese, meat, eggs, etc., whole grains, etc. We are all at a total loss on this one. Any suggestions?
Answer:
I do not have an answer to your questions, unfortunately. The considerations that came to my mind were already addressed by you, namely possible fungal infection or a nutritional imbalance. I doubt the former if her diabetes is well controlled. The latter is still a possibility in terms of what are sometimes referred to as “micronutrients.” These usually include various minerals, etc.
I do not know whether your situation would allow you a conference with a dermatologist, but that is where I might send you. In the meantime, despite her consumption of milk and vegetables, I would ask you to consider giving her a once-a-day type of complete multi-vitamin which includes iron and at least 15 mg of zinc and see if you note changes over the next few months.
DS
