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In today’s post I will be discussing the skin changes that are seen in people who are suffering from Diabetes Mellitus.
Diabetes mellitus is a group of metabolic disorders which presents as an increase in the blood glucose level in the body (hyperglycemia) resulting from either direct defect in the insulin secretion, insulin action or both. The diagnosis is achieved by knowing the plasma glucose level which should follow any of the criterias mentioned below-
- Random plasma glucose (RBS) >200 mg/dl, with classical signs and symptoms.
- Fasting blood glucose (FBS) >126 mg/dl or higher on more than one occasion.
- Abnormal glucose tolerance test (OGTT), where the glucose level is >200mg/dl or higher 2 hours after 75 gm of oral glucose load.
- Glycated haemoglobin(HbA1c) > 6.5 %
The various types of diabetes are-
- Diabetes insipidus
- Diabetes mellitus
- Maturity onset diabetes of the young (MODY)
- Gestational diabetes mellitus (seen in pregnancy)
- Latent autoimmune diabetes in adults (LADA)
- Neonatal diabetes mellitus (NDA)
Other than full fledged diabetes there are few more conditions which are seen in patients with increased plasma glucose levels in the body that do not fit the criteria of diabetes but are prone to develop it in the future if not controlled. They are as follows-
- Euglycemia- in this state the individual has a fasting glucose value >110 mg/dl but less than 126 mg/dl, or <140 mg/dl following an OGTT.
- Impaired glucose tolerance- The serum fasting glucose levels in patients is >110 mg/dl but < 126 mg/dl. OGTT values >140 mg/dl but <200 mg/dl. This condition is majorly responsible for increase in progression to future diabetes in the patients.
The common symptoms associated with diabetes are-
- Polyuria- increased urination. There is presence of glycosuria i.e. presence of glucose in urine.
- Polyphagia- increased consumption of food.
- Polydipsia- increased thirst.
- Increased tiredness/ fatigue
- Skin infections/changes
- Headaches
- Leg cramps
Apart from the signs and symptoms experienced by the internal organs of the body a lot many are even visible on our skin.
The various signs of diabetes mellitus seen on the skin are-
- Dry skin– also referred to as xerosis. Many people who have diabetes can experience dry skin along with itching. This is the most common manifestation that is seen in the patients.
- Diabetic bulla– Bulla is a fluid filled elevated lesion seen on the skin surface. Many people experience the formation of bullae in the lower extremities or legs. These are tense and non-inflammatory in nature.
- Diabetic dermopathy– in this condition there are multiple wrinkled atrophic macules/patches on the legs.
- Infections- there can be either bacterial or fungal infections on the skin. These microorganisms thrive when the glucose/sugar levels are high in the body leading to formation of pustules, papules, cysts or acne. They can also disturb the normal microbial flora on the skin leading to overgrowth of yeast which can result in tinea versicolor (hyperpigmented or hypopigmented patches on the skin) or even malassezia folliculitis (fungal acne).
- Acanthosis nigricans– they appear as velvety hyperpigmentation on the flexural area commonly seen at the back of the neck. Acanthosis nigricans are associated with insulin resistance in the body. Other conditions causing acanthosis nigricans are obesity, androgen excess, drug induced, idiopathic and certain malignant conditions in the body.
- Scleredema– scleredema is a condition in which there is hardening of the subcutaneous tissue of chest, arms.
- Generalised granuloma annulare– this is an annular, red, non-scaly plaque seen typically on the dorsum of the hand. In patients with diabetes mellitus, generalised granuloma annulare is seen.
- Necrobiosis lipoidica– they present as yellow wrinkled patches on the shin which might ulcerate over time. They are characterized by well circumscribed, waxy, depressed, yellow brown plaques on the skin.
Hope you found this article helpful
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