Diabetes Skin Diseases Should be Monitored daily
More than two million Canadian have diabetes. Chronic or non healing wounds take an immense toll on American health and on health care systems. It particularly affects millions of patients with impaired mobility, as well as those with diabetes. Researchers believe that the body may actually “rob” the skin of moisture to compensate for high blood glucose.
The dermatologist advised that the skin can give early indicators of diabetes and even someone’s predisposition to the illness. Early detection and heightened awareness of diabetes and skin issues, Dr. Kapoor said, could prevent lower limb amputation, blindness and heart disease. Doctors are encouraging all of the diabetes patients to examine their feet at least daily and look for sores, breaks in the skin, calluses or rashes.
Internal disease processes are often associated with cutaneous manifestations. Such manifestations of diabetes include necrobiosis lipoidica diabeticorum, diabetic thick skin and stiff joints, diabetic dermopathy, bullosis diabeticorum, cutaneous infections, scleredema adultorum, eruptive xanthomas, and cutaneous findings associated with vascular disease and autonomic neuropathy.
Blood flow to the skin of a normal foot can readily increase by 100 times if necessary, to conduct heat away from challenged areas. Impaired circulation and impaired endothelial dilatation (which are common in patients with diabetes) may make this increase in blood flow impossible, and the resultant burn may not cause pain if peripheral neuropathy is present.
Diabetes may leave you more susceptible to skin problems, including bacterial infections, fungal infections and itching. Recently study found that applying insulin directly to skin wounds significantly enhanced the healing process. Skin wounds in rats treated topically with insulin healed faster” surface cells in the epidermis covered the wound more quickly and cells in the dermis, the deeper part of the skin, were faster in rebuilding blood vessels.
Physicians should be aware of the fact that diabetes patients have an increased risk of common infections. The researchers found that compared to patients in the control group, the odds were significantly higher that both type 1 and type 2 diabetic patients would develop infections of the respiratory tract, skin and mucous membranes and urinary tract. Diabetics' risk for recurring infection was also higher.
Experts suggesting an association between psoriasis and two potentially serious medical conditions – diabetes and atherosclerosis, also known as hardening of the arteries. They found a higher occurrence of diabetes and atherosclerosis in psoriasis patients compared to patients without psoriasis. Psoriasis is a chronic skin condition characterized by thick, red, scaly plaques that itch and sometimes bleed, causing considerable discomfort and emotional stress for patients.
About two thirds of young patients with type 1 diabetes may have skin disorders, some of which develop early in the course of the disease, according to study results published in the journal Diabetes Care.
While diabetes is known to be associated with a number of skin disorders, "there is a relative paucity of studies looking at the prevalence of skin changes in young patients with type 1 diabetes," Dr. Milos D. Pavlovic, of the Military Medical Academy, Belgrade, Serbia, and colleagues write. Skin problems usually develop after diabetes does, but they may also be the first sign or may even precede a diagnosis.
The team compared the presence and frequency of skin manifestations in 212 young patients with type 1 diabetes ranging in age from 2 to 22 years and 196 healthy subjects matched to the diabetics for age and other characteristics who served as controls.
Overall, 67 percent of diabetic patients had at least one skin disorder versus 26 percent of the control subjects. Active skin conditions that were considered to be associated with diabetes were observed in 38 percent.
Ichthyosis, dry patches of scaly skin, was seen in 22 percent of the diabetics compared with 3 percent of the controls. Rubeosis, abnormal growth of blood vessels causing red discoloration, occurred in 7.1 percent of diabetics and none of the controls. Fungal infections were observed in 4.7 percent of diabetic patients and 1.5 percent of controls.
The authors also note that the frequency of skin reactions to insulin therapy was fairly low, at 2.7 percent.
Based on the frequency and variety of skin diseases in these patients, Pavlovic's team suggests that a dermatologist should be included in the group of doctors who treat patients with type 1 diabetes.
Some of the most common skin conditions associated with diabetes are:
- Major problems diabetics face because of their disease are skin and foot disorders.
- Vitiligo: a condition where the skin’s pigment is destroyed leaving the affected area white
- Diabetic dermopathy: This is the commonest skin disease seen in diabetics. Skin signs are commonly found over the shins and appear as brown scars. The brown spots may be preceded by red or blistering spots.
- Corn: a thickening of the skin of the feet or hands, usually caused by pressure against the skin
- Skin ulcer : a break or deep sore in the skin is most common for diabetes patients.
- Occasionally — especially when you first use insulin — you may notice redness and some slight swelling at the injection site. This may result from impurities in the insulin or could stem from a small amount of alcohol getting into the underlying tissue.
- Scleroderma diabeticorum: thickening of the skin on the back and neck
- Excess dryness: Overly dry skin on feet often leads to cracked heels and a hard growth of skin, usually on the outer edge of the heel. Diabetics are particularly affected, since rough, dry and scaly skin affects most people with diabetes over the age of 64.
- Acanthosis nigricans: discoloration and thickening of the skin
- Bacterial and fungal infections: these infections can occur anywhere on the body
- Calluses: thick, hardened areas of the skin, usually on the foot, caused by friction or pressure
- Diabetic neuropathy : Diabetes can damage the nerves resulting from occlusion of blood vessels to the nerves. This can cause a burning and tingling sensation and numbness of the feet. Patients also have reduced or loss of pain sensation and may develop skin sores and ulcers on the feet due to trauma if good foot care is not instituted.
- Another skin condition, which can be symptomatic to diabetes, is Acanthosis Nigricans. Its symptoms include significant darkening and thickening of skin folds under the arms, neck, elbows or knees.
- Another highly common indicator of diabetes, or a predisposition to it, was said to be crochordon – better known as skin tags. The small, benign growths are generally found around the neck, face and chest.
- Diabetes is linked to thickening of the skin.Diabetes leads to reduced blood circulation to the skin (microangiopathy).
- Nail-fold capillary hypertension may develop early in the course of diabetes, before the emergence of microvascular disease, and may be influenced by changes in metabolic control.
One of the most common difficulties a diabetic will experience with his or her feet involve toenails. Often a diabetic's toenails will grow in an irregular shape and if the patient has difficulty reaching his or her feet, it may be difficult to cut the nails properly. This can result in a fungal infection or skin irritation. So, they should always try to cut the nail straight across and gently file sharp corners with an emery board.