According to the Centers for Disease Control, an estimated 37.3 million
Americans have diabetes, that’s about 11.3% of the entire population. On
top of that, another 96 million adults have prediabetes, making this one of the
single most damaging and prevalent diseases in the United States (1).
Unfortunately, the health issues related to diabetes are physiologically
widespread, affecting multiple organ systems. This results in an array of
uncomfortable and hard-to-treat symptoms that researchers at HCD Anti-
Aging Laboratories are working diligently to relieve. The Essential-Dm
Mani/PediPod manicure/pedicure formula, with ingredients supported by
research, is one treatment they have provided, specifically to support skin
ailments caused by diabetes.
Epidemiologic research has shown that in a whopping 79.2% of
individuals with diabetes, skin conditions will be present. This includes an
array of microbial skin infections and inflammatory skin diseases, as well as
chronically dry skin, all of which can result in uncomfortable and hard to treat
symptoms (2). Because diabetes is so hard to treat with success, finding
alternative ways to prevent and support these presentations can be essential
to maintaining the quality of life.
The Essential-Dm Mani/PediPod contains ingredients to nourish and protect
the skin with the goal of soothing current issues while preventing future
problems. By combining medical philosophies from both eastern and western
traditions, it has been designed to include green tea extracts, grape seed
extract, rosemary, arnica, vitamin E, and benzalkonium chloride, all of
which contain anti-inflammatory and/or antimicrobial properties.
A concern with diabetic patients is that when blood sugars are uncontrolled
long-term, peripheral circulation is reduced, and therefore so is the ability of
the skin to heal - in some cases, this can be so severe, that patients can lose
the limb. Green tea, containing a high relative content of an active
polyphenol known as epigallocatechin gallate, or EGCG, is one medicinal
herb that can combat some of these skin concerns, specifically by
supporting wound healing. Though the specific mechanisms are quite
complex, ECGC has been found to have antioxidant, anti-inflammatory,
antimicrobial, angiogenic, and antifibrotic properties, which benefit all
stages of wound healing (homeostasis, inflammation, proliferation, and
A 2019 animal study looked a little closer. They referenced the knowledge that
in mice with diabetes, the persistent inflammation in the later stages of wound
repair is specifically what delays healing. They found that ECGC, the active
constituent in green tea, was able to inhibit the accumulation of white
blood cells, the inflammatory cascade, and a specific signaling pathway
known as Notch-1. Therefore, they concluded that EGCG was a novel
potential medicine to treat chronic wounds, especially in diabetic patients. (4)
Grape seed extract, another ingredient of the Essential-Dm Mani/PediPod
formula, is also supported in the literature as a treatment for wound healing
and other diabetic complications. Though it is usually thought of as an oral
supplement, a 2014 study by Hemmati et al, showed it’s potential benefit
when applied topically. These researchers performed surgery on small skin
lesions, with the study group receiving 2% grape seed extract cream and the
controls receiving a placebo. After monitoring the healing process for 21 days,
they found that the treatment group had complete repair of wounds by day 8,
compared to day 14 in the control group, which was statistically significant.
They attributed this success to the ability of the grape seed extract to release
endothelial growth factors, therefore closing the wound and improving
circulation, as well as its ability as an antioxidant and antibacterial,
reducing inflammation and the risk of infection. (5) In diabetics, where
wounds go unnoticed and healing times are extended, this could be a novel
way to prevent complications.
Though rosemary is also known to improve wound healing, it has a bit more
of a broader spectrum when it comes to its actions on skin health. The ability
of its active constituents to act topically as an antioxidant and anti-
inflammatory has made it a commonly used herbal medicine both in the
pharmaceutical and cosmetic industries. For example, carnosic acid, one of
the active molecules in rosemary, was found to act as an anti-inflammatory,
specifically by mediating microcirculation – pharmaceutically, this would
improve healing and skin health; cosmetically, it would reduce redness,
swelling, and signs of aging. A comprehensive review of potential topical
applications also cited studies touting rosemary as an anti-fungal, a
protectant against UV damage, adjunctive treatment for skin cancers, a
possible treatment to improve the appearance of cellulite, and a possible
promoter of hair growth in individuals with alopecia. (6) All these potential
benefits is what led it to be added to the Essential-Dm Mani/PediPod
The last herb included in the formula is colloquially known as Arnica. Though
most commonly thought of as a strictly musculoskeletal herb, the actual
mechanisms behind why it works for strains, sprains, and bruising may
indicate significant implications on skin health. Much of arnica's success in
studies is attributed to its strong antioxidant activity, with one study
finding that at concentrations up to 100 mg/L, it possessed a significant
protective effect against hydrogen peroxide-induced oxidative stress
(inflammation), especially in skin cells. (7) In the skin of diabetics, an imbalance
of free radicals and antioxidants within the skin cells causes tissue damage
and delayed wound healing. (8) Therefore, supplying the strong
antioxidants from arnica to the skin causes an overall improvement in
tissue health, hydrating, protecting, and repairing the skin.
Herbs aren’t the only remedies that are in the Essential-Dm Mani/PediPod,
however. Vitamin E, a fat-soluble vitamin known for its significant health
effects, has also been included. Like many of the herbs, much of vitamin E’s
popularity in dermatology and cosmetics is attributed to its antioxidant
properties. However, it also has the ability to moderate the biosynthesis of
collagen and glycosaminoglycans in the skin. Therefore, on top of supporting
wound healing, reducing inflammation, and hydrating the skin, it also
supports the integrity and strength of the skin itself. (9) This could prevent
known diabetic complications such as infection or ulcer formation. In addition
to these topical effects, vitamin E has shown to have neuroprotective and
cardioprotective effects when taken orally. Both circulatory and nerve
conduction issues occur in diabetics, especially when blood sugars are poorly
controlled. Theoretically, topical application of vitamin E could benefit
superficial nerves and microvasculature, improving outcomes with diabetics
experiencing complications. (10)
These natural compounds are combined with benzalkonium chloride, a
potent FDA-approved antimicrobial that is known to be minimally irritating
to the skin. Researchers have worked diligently to combine traditional
medicinal philosophies with modern medicine, providing a new, novel way to
support patients suffering from various skin conditions. The Essential-Dm
Mani/PediPod formula, containing green tea extracts, grape seed extract,
rosemary, arnica, and vitamin E, truly combines beauty with health,
specifically formulated with diabetic patients in mind, preventing and
aiming to heal painful, often debilitating symptoms.
Dr. Mary Hall, ND, LAc
Medical Writer and Medical Advisory Board
“Diabetes: National Diabetes Statistics Report.” Centers for Disease
Control and Prevention. https://www.cdc.gov/diabetes/data/statistics-
Duff, M., Demidova, O. Blackburn, S., Shubrook, J. 2015. Cutaneous
manifestations of diabetes mellitus. Clin Diabetes: 33(1): 40-48.
Xu, F., Lv, Y.L, Zhong, Y.F., Xue, Y.N., Wang, Y., Zhang, L.Y., Hu, X., Tan, W.Q.
2021. Beneficial effects of green tea ECGC on skin wound healing: a
comprehensive review. Molecules: 26(20): 6123.
Huang, Y.W., Zhu, Q.Q., Yang, X.Y., Xu, H.H., Sun, B., Wang, X.J., Sheng, J.
2019. Wound healing can be improved by (-)-epigallocatechin gallate
through targeting Notch in streptozotocin-induced diabetic mice. FASEB J:
Hemmati, A.A., Foroozan, M., Houshmand, G., Moosavi, Z.B., Bahadoram,
M., Maram, N.S. 2014. The topical effect of grape seed extract 2% cream on
surgery wound healing. Glob J Health Sci: 7(3): 52-58.
De Macedo, L.M., dos Santos, E.M., Militao, L., Tundisi, LL, Ataide. J.A.,
Souto, E.B., Mazzola, P.G. 2020. Rosemary (Rosmarinus officinalis L., syn
Salvia rosmarinus Spenn.) and its topical applications: a review. Plants
(Basel): 9(50: 651).
Craciunescu, O., Constantin, D., Gaspar, A., Torna, L, Utoiu, E., Moldovan,
L. 2012. Evaluation of antioxidant and cytoprotective activities of Arnica
montana L. and Artemisia absinthium L. ethanolic extracts.
Deng, L., Du, C., Song, P., Chen, T., Rui, S., Armstrong, D. Deng, W. 2021.
The role of oxidative stress and antioxidants in diabetic wound healing.
Oxid Med Cell Longev: ecollection. Mohammad Abid Keen and Iffat
Hassan. 2016. Vitamin E in dermatology. Indian Dermatol Online J: 7(4):
Zaffarin, A.S.M., Ng, S.F., Ng, M.H., Hassan, H., Ekram, A. 2020
.Pharmacology and pharmacokinetics of vitamin E: nanoformulations to
enhance bioavailability. Int J Nanomedicine: 15: 9961-9974.