By Shelley Diamond, BScPhm
The skin offers a window to what is happening inside the body, so changes to the skin may signal a more serious health problem, often serving as a marker for underlying internal disease. For those living with diabetes, hyperglycemia affects skin homeostasis. Skin disorders may appear during the course of the disease or often may be the first sign of the condition.
How common are skin disorders in people with diabetes?
Skin disorders occur more commonly in those with type 2 diabetes, however overall prevalence has ranged from approximately 51 to 97 per cent of patients. The most frequent disorder is infection, which occurs in approximately 20 per cent of diagnosed patients.
What types of cutaneous manifestations occur?
The cutaneous presentations can be divided into four categories, including:
What are the presenting features of diabetes-related skin disorders?
People with diabetes may present initially with xerosis, or calluses and fissures.
Among other diabetes-related lesions:
How can you help your patients?
One of the most important ways to prevent serious skin-related complications is to help your patients living with diabetes manage their blood glucose levels since chronic hyperglycemia can lead to several skin disorders. Proper foot care (washing daily and drying thoroughly, applying moisturizer other than between the toes, inspecting daily for cuts and scrapes) is essential in minimizing the risk of foot ulcers.
Skin disorders are often underdiagnosed in people with diabetes, and pharmacists may be the first touchpoint for questions about skin complications. Lack of diagnosis and treatment with early-stage skin disorders can lead to clinical worsening, and progression to foot neuropathy, ulcers and even amputation, which can eventually result in fatalities. Recognition of early symptoms is vital to advise patients accordingly so they can avert serious life-threatening complications.
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