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Written by Stephanie Thurrott, answers and information provided by Jordan R. Wagner BSN, RN, CDCES
If you have type 1 or type 2 diabetes, you probably know that there are many ways the condition can affect your health. You’ve likely been warned about your increased risk of developing medical conditions like heart disease, vision problems, and kidney issues.
But you may not realize that diabetes affects your skin as well.
We connected with Jordan Wagner, RN, a diabetes educator with Banner - University Medicine to learn more about why diabetes can cause skin conditions and what you can do to avoid or minimize them.
Your skin is the largest organ in your body, and it’s filled with nerves and blood vessels. “High glucose levels impact every organ in the body, so it’s no surprise that your skin is impacted,” he said. “High blood glucose levels can reduce the blood flow to your skin. Plus, your skin can lose moisture when it’s pulled back into the body in an attempt to lower blood glucose levels.”
Here are some of the ways diabetes can impact your skin. Keep in mind that these problems are more likely to show up in people who have uncontrolled diabetes. “People who manage their blood glucose levels well are much less likely to see impacts on the skin,” Wagner said. “Complications do not have to happen. They are related to uncontrolled diabetes. The best advice I can give is to learn to manage diabetes well.”
1. Acanthosis nigricans
This black discoloration of the skin can appear around the back of the neck, armpits, and groin. It’s more commonly seen in people with obesity and type 2 diabetes.
2. Dry, itchy, cracked or irritated skin
If you routinely have high blood sugar levels, your body tries to lower them by diluting your blood and creating more urine. To do this, your body pulls water from other areas, including the skin. This can leave your skin feeling dry, itchy, cracked or irritated.
3. Fungal and bacterial infections
When you have higher blood glucose levels you have a higher risk of infection, since those high glucose levels make it harder for your immune system to function at its best. Additionally, people with diabetes are more prone to fungal infections such as athlete’s foot and yeast infections. “A small cut on the skin can quickly turn into a major problem if you have uncontrolled diabetes,” Wagner said.
4. Nonhealing wounds or ulcers
Over time, high glucose levels lead to high levels of inflammation in your body, and wounds don’t heal as well with inflammation. Nerve damage from diabetes can make nonhealing wounds even more serious.
Wagner shares an example. A person with chronically high glucose levels may develop peripheral neuropathy (nerve damage). That could make them unable to feel pain in their feet. If they get a cut on their foot, they might not feel it and it could lead to a major infection or wound that doesn’t heal. “Chronic ulcers from diabetes are related to higher rates of amputations,” he said.
5. Diabetic dermopathy
These light brown or reddish, irritated, shiny spots often appear on bony areas like the shins. They are typically related to poor circulation caused by high glucose levels over time. “Poor circulation means that nutrients are not being delivered to the skin as well as they should be,” Wagner said.
6. Tape intolerance
Tape intolerance is indirectly related to diabetes itself, but many people with diabetes use insulin pumps or continuous glucose monitors (CGMs) and need to use tape to keep these devices in place. You can develop skin irritation, pain and redness in areas where the tape was placed.
7. Lipohypertrophy
This condition is also indirectly related to diabetes. But many people with diabetes use insulin or may use it in the future. When your skin is injected repeatedly in the same locations, fat tissue can build up underneath the skin and cause a firm, raised area on the skin.
What can you do to keep your skin healthy if you have diabetes?
You probably noticed that most of these conditions are caused when you have high blood glucose levels over an extended period. “Without a doubt, the number one priority is to control blood glucose levels,” Wagner said. That takes consistency in managing your diabetes. You’ll need to:
Take insulin or other medications as prescribed.
Eat a healthy, well-rounded diet.
Get regular physical activity.
Lower your stress levels.
Prioritize sleep.
“All of these habits will help control glucose levels and lead to better outcomes for your skin,” Wagner said.
You can check your blood glucose levels with a glucometer or a CGM. You’ll want to aim for a range of 80 to 130mg/dL. The closer you can get to non-diabetes levels—70 to 100mg/dL—the better.
For tape intolerance, you can try using skin preps or sprays designed to create barriers between the skin and the tape.
For reactions to injections, rotation is important. “Do not give injections in the same location repeatedly. “Switch sides and move injection spots at least the distance of a quarter if you are using the same location,” Wagner said.
If you’re seeing skin complications, they could be a sign that something is happening underneath your skin. See your doctor or a trusted health care provider for evaluation and care. You may want to ask your doctor to recommend a diabetes educator or nutritionist.
The bottom line
Diabetes can lead to a range of skin problems, especially when it’s not well-controlled. Taking steps to keep your blood glucose levels in healthy ranges can reduce the likelihood that you’ll develop these problems.
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