Diabetes and the Skin: Complications and Prevention Tips

Diabetes is one of the leading causes of death and disability across the world, affecting approximately 530 million people in 2021. The global burden of the disease is also projected to increase significantly in the coming years, with some estimates putting the number of people diagnosed with the condition at 1.31 billion by 2050.¹

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The chronic disease, characterized by elevated blood glucose concentrations, can lead to numerous serious health complications if left uncontrolled. Patients with diabetes are at an increased risk for heart and blood vessel damage, nerve damage, kidney damage, and osteoporosis, as well as Alzheimer disease and dementia.²

Another common area of concern for patients with diabetes is the potential for complications of the body’s largest organ: the skin. Between 30% and 70% of patients with diabetes will experience a skin condition at some point in their life.³ Skin conditions can also often be the first sign that someone has diabetes, which is why it is important to always keep an eye on any noticeable changes.⁴

“Given the high prevalence of diabetes and its associated skin complications, it is crucial to address this issue and explore strategies for its prevention and management,” wrote researchers in a review article published in the journal Cureus.⁵ “Early detection and treatment of skin complications can improve outcomes and reduce the risk of serious complications.”

Diabetes Skin Complications

Acanthosis nigricans

One of the more classically known skin complications of diabetes, acanthosis nigricans is more common in patients with type 2 diabetes and can impact men and women of all ages. The condition presents as multiple plaques that are gray to dark brown in color with a thickened, velvety surface. It commonly appears on the back of the neck, elbows, and groin.⁶

Diabetic dermopathy

The most common diabetic skin condition, diabetic dermopathy affects as many as 50% of patients with diabetes. Men and individuals older than age 50 are at highest risk for the complication, which usually occurs as a late complication of diabetes. It presents as rounded, dull, red papules that eventually turn into brown macules with a fine scale. They commonly appear over bony areas, such as the front of the shin or forearms.⁶

Diabetic foot syndrome

Diabetic foot syndrome has a prevalence of approximately 4% to 10% and is slightly more common in patients with type 1 diabetes. The condition represents a significant cause of morbidity, mortality, hospitalization, and reduction in quality of life. It initially presents as calluses and dry skin, but in later stages turns into chronic ulcers and other malformations of the feet. Diabetic foot syndrome also makes patients more prone to fungal infections, which can infect and complicate the ulcers.⁶

Scleredema diabeticorum

A chronic, slowly progressing skin disorder that affects approximately 2.5% to 14% of patients with diabetes, scleredema diabeticorum affects mostly women and those over the age of 20, although it can impact patients of all ages. The condition presents as worsening, thickened skin. The most commonly affected areas are the upper back, shoulders, and back of the neck.⁶

Taking Care of Your Skin

According to the CDC, the skin is a good indicator of overall health.⁷ When skin complications arise in patients with diabetes, they may be the result of high blood sugar, or they may mean that a change in treatment is needed. The American Diabetes Association notes that it is important to take good care of the skin, and there are several measures that can be taken to prevent any potential complications.⁴

These include the following:

• Managing diabetes effectively.
• Keeping skin clean and dry.
• Using moisturizer to prevent dry, cracked skin.
• Avoiding excessively hot showers or baths.
• Treating any cuts, wounds, or burns by washing and applying antibiotic cream or ointment, as well as covering any minor cuts with sterile gauze.
• Keeping the home humid during cold, dry months.
• Using mild shampoos.

If patients are unable to solve these skin issues on their own, consider referring them to a dermatologist for additional care.

READ MORE: Diabetes Resource Center

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References

1. GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021 [published correction appears in Lancet. 2023 Sep 30;402(10408):1132]. Lancet. 2023;402(10397):203-234. doi:10.1016/S0140-6736(23)01301-6

2. Diabetes complications and risks. American Heart Association. April 2, 2024. Accessed May 15, 2024. https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks

3. Vâță D, Stanciu DE, Temelie-Olinici D, et al. Cutaneous manifestations associated with diabetes mellitus-a retrospective study. Diseases. 2023;11(3):106. Published 2023 Aug 18. doi:10.3390/diseases11030106

4. Diabetes and skin complications. American Heart Association. Accessed May 15, 2024. https://diabetes.org/about-diabetes/complications/skin-complications

5. David P, Singh S, Ankar R. A Comprehensive overview of skin complications in diabetes and their prevention. Cureus. 2023;15(5):e38961. Published 2023 May 13. doi:10.7759/cureus.38961

6. Labib A, Rosen J, Yosipovitch G. skin manifestations of diabetes mellitus. [Updated 2022 Apr 21]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481900/

7. Diabetes and your skin. CDC. December 19, 2023. Accessed May 15, 2024. https://www.cdc.gov/diabetes/signs-symptoms/diabetes-and-your-skin.html?CDC_AAref_Val=https://www.cdc.gov/diabetes/library/features/diabetes-and-your-skin.html