Diabetes Mellitus, DM for short, is a metabolic disorder causing an abnormally high blood sugar (glucose) level due to either insufficient insulin production or shear resistance to absorb the glucose by the body tissues. DM affects not only carbohydrates but also proteins and fats usage in the body. Obviously, treatment is therefore targeted at keeping the blood glucose down to as near normal levels as possible- which is no small feat. That can only be achieved by a highly regimented food content on an eating timetable with strict drug compliance either with tablets and/or by self-injection with Insulin. FYI DM does not belong to the same category of sudden acute ailments like infection for instance, that are cured after a course of prescribed medications. The current treatment modalities can only ‘manage’ the condition, that is, to keep the patient at health levels as near normal as possible to prevent it from getting worse. That is why DM is called a chronic disease because it gets to stay around for a long time, and more often, for a lifetime.
Invariably after several years complications often sets in. Understandably, it is pretty easy to relate with how DM can affect the internal organs like the heart, kidneys and liver because they are probably bathed in blood anyways right? (Not quite) but what business has it got with the skin?
Here is the thing with DM, blood glucose level is only one measure of the diverse metabolic consequences of DM. DM causes several disruptions at the molecular level causing covalent bonding via chemical reactions of a wide variety of proteins (called Glycosylation if you care to know), like Haemoglobin in Red blood cells, Collagen in the Skin, Tubulin in the nerves, bla bla bla, you get the gist. So it is the accumulation of these glycosylated products that are to blame as they stimulate further injury and occlude miniature blood vessels causing abnormal blood flow and limiting the supply of oxygen and other nutrients. Undoubtedly, the duration and degree of high uncontrolled blood sugar matters a lot.
The Effect of uncontrolled diabetes on the skin?
Well poor blood glucose control impairs the functionalities of the White blood cells- our foot soldiers, leading to infection (conversely, infections may also lead to a loss of glycaemic control too). The effect is an unusually increased susceptibility to Skin Infections like Recurrent Abcesses (from Staph), fungal infections of the skin (Candidiasis), Xanthomas from Cholesterol deposits, and frequent injuries that often turns to ulcers due to the damage caused on the nerve endings and blood vessels.
I wish that was the worst DM could do on the skin but there are more Diabetes-specific skin issues. Permit me to warn you ahead of time to forgive their Latinized names. I will make it up by adding descriptive tags. Here they are:
- Diabetic Cheiro-Arthropathy (Stiff Skin)- causing difficulty in moving the finger joints due to the tightness over its skin
- Diabetic Dermatopathy- appearing like small and well rounded brownish bumps/papules
- Necrobiosis Lipoidica- due to fat deposits and collagen disorders causing a patch of prematurely dying skin that is spreading over the shin and may become infected and become an ulcer
- Blisters- increased susceptibility to blisters usually on the feet and may occur on the hands too
- (Diffuse) Granuloma Annulare- is characterized by clusters of small skin papules that often form into rings. It is typically more common in children and young adults so whenever seen in abundance all over the body in the older age group, it is more likely to be associated with DM.
Knowing this stuff is pretty vital because often times, weird-looking rashes can trigger undue anxiety. Looks are undeniably important as they are strongly linked to self-esteem but also, with the proximity of Chemists and easy access to over-the-counter skin care products without prescriptions, getting a proper diagnosis of a skin rash may just prove to be life saving.