Introduction

Skin problems may be the first visible signs of diabetes, according to the American Diabetes Association (ADA). Diabetes can make existing skin problems worse. New skin problems may also appear.

According to research, nearly 97% of people with diabetes experience a skin condition.[1] Understanding why these problems arise, how they are treated, and the potential complications is crucial for effective management.

Skin Conditions Associated with Diabetes

Itching

Poor circulation and nerve damage associated with diabetes can lead to itching. Excessive scratching, particularly in the lower legs and feet, can lead to skin damage and increase the risk of infections.

Dry Skin

High blood sugar can cause dehydration, leading to dry and flaky skin. Dry skin is not only uncomfortable but also increases the risk of developing other skin problems, such as itching, cracking, and infections.

Acanthosis Nigricans

Dark, thick, velvety patches typically found in the folds and creases of the skin, such as the neck, armpits, groin, and beneath the breasts. It presents in 90-95% of cases of childhood diabetes.[3], associated with insulin resistance and is more common in people with prediabetes or type 2 diabetes, especially if the individual is obese or has PCOS. Besides skin irritation, it may have a psychological impact.

Diabetic Blisters

Rare skin lesions, filled with a clear fluid, may develop suddenly on the hands, feet, legs, or forearms, they are painless and usually heal naturally

Diabetic Dermopathy/ Shin Spots

Also known as shin spots, diabetic dermopathy presents as light brown or red patches on the skin, often on the shins. They are believed to be related to a weak immune system, poor circulation, and nerve damage.

It is a common condition; nearly 30% of people with diabetes have diabetic dermopathy.[2] While these patches are harmless, they can be unsightly and may take a long time to fade. Sometimes, though, diabetic dermopathy lesions may be mistaken for ulcers, leading to unnecessary treatment or complications.

Infections

Diabetes weakens the immune system, making individuals more susceptible to skin infections. Bacterial and fungal infections are most common

Bacterial infections

Bacteria thrive when there is too much glucose (sugar) in the body specially staphylococcus (staph). infections cause tissue (cells that make up organs and other body parts) to become inflamed, hot, swollen, red, and painful. Common bacterial infections include those on the eyelids, hair follicles, and fingernails.

Fungal infections

They usually develop in warm, moist folds of the skin and create itchy rashes surrounded by tiny red blisters and scales, Common fungal infections include jock itch, athlete’s foot, ringworm, and vaginal infections.

Necrobiosis Lipoidica

The condition is characterized by the development of patches of red, brown, or yellow skin lesions that gradually become patches of swollen or hard skin. It usually happens due to poor blood circulation.

Digital Sclerosis

Tight, thick, and waxy skin develops on the fingers, potentially causing stiffness and difficulty in moving the finger joints. 1 in 3 people with type 1 diabetes have digital sclerosis.[1] Tight, thick, and waxy skin develops on the fingers, potentially causing stiffness and difficulty in moving the finger joints

Vitiligo

Vitiligo is characterized by the loss of skin color in patches, resulting from the destruction of melanocytes, the cells responsible for producing pigment in the skin. It is usually associated with other autoimmune diseases, such as adult-onset type 1 diabetes mellitus.

Diabetic Ulcers

Most common diabetic ulcer are foot ulcers. Poorly controlled diabetes often makes it hard for sore wounds to heal. Delaying treatment may cause complications like osteomyelitis and gangrene.

Treatment and Prevention

Dermatologist recommend the following preventive measures and treatment for diabetic skin complications

Keep Blood Sugar Levels Appropriate

Preventing diabetes-related skin problems can be achieved by maintaining blood sugar levels within the target range. Key components include consistent medication adherence, regular monitoring, and lifestyle changes like regular exercise and a nutritious diet.

Moisturize every day

Maintaining hydrated skin makes it more pliable and helps shield it from fissures, which can harbor bacteria.
Dermatologists advise the following for optimal results:

• Use an ointment or cream instead of a lotion. Lotions are less effective than creams and ointments for healing dry skin.
• Make an ointment or lotion using ceramides that is fragrance-free. The term “unscented” items should be avoided as they have concealed fragrances, making them difficult to smell.
  When your skin feels dry or itchy, apply your lotion or ointment after taking a bath or swimming.
• Don’t bath in hot water which takes away the moisture of your skin

Treat dry, cracked heels.

This can stop non-healing sores, a dangerous infection, and other issues. Dermatologists advise performing the following before going to bed

• Use a lotion on your heels that has between 10% and 25% urea.
• Cover the urea cream with a layer of thick ointment, such as petroleum jelly.
• While you’re in bed, put on white cotton socks to assist retain moisture.

Seek immediate medical care for a skin or nail infections

People who have diabetes can develop an infection more easily than people who have a healthy endocrine system. An infection can quickly become serious.

Protect the Skin/ Suncreen and clothing modification

Sunscreen and appropriate clothing can help prevent sunburn and lower the chance of skin damage

OTC Remedies

Some skin issues linked to type 2 diabetes can be managed with the aid of over-the-counter medicines they includes over-the-counter antifungals such clotrimazole (Lotrimin AF, Mycelex) + Lotions and moisturizers to alleviate parchedness

Prescription Medications

In some cases, a doctor will prescribe medications or other treatments such as:

• topical or oral antibiotics to treat skin infections
• stronger antifungal medications
• insulin therapy or other drugs to manage blood sugar levels

Alternative remedies

Some non-drug remedies for diabetes-related skin problems such as talcum powder to prevent friction in skin folds and lotion formulated for dry skin, which can reduce itching

Before using any natural or alternative remedies, consult your doctor. Even all-natural herbal supplements can interfere with any medications you’re currently taking.

Conclusion

Taking good care of one’s skin is crucial for diabetics in order to avoid and treat common skin diseases. It is possible to reduce the risk of problems and preserve general skin health by controlling blood sugar levels, practicing excellent hygiene, moisturizing frequently, and treating any irregularities in the skin right once. An essential part of managing diabetes is routine skin examinations and quick medical intervention for any troubling changes.