Cutaneous manifestations of diabetes mellitus type 2: prevalence and association with glycemic control

Abstract

Objective To determine the frequency and pattern of skin disorders in patients with type 2 diabetes mellitus and their association with glycemic control in our diabetics. Methods This descriptive, cross-sectional study was conducted at departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital, Karachi from 1 st January to 30 th June 2014. Adult patients belonging to both genders having diabetes mellitus type 2 with cutaneous manifestations were included. After taking the informed consent, demographic details, duration of diabetes, mode of treatment for diabetes, types of footwear, foot care and glycemic profile were documented. Results In 203 patients (41% male and 59% female), mean age was 50 + 11 years and mean duration of diabetes 8.5 + 7 years. Mean HbA1c was 8.6 + 1.5 with 68% patients having unsatisfactory glycemic control. Most frequently observed skin disease was bacterial infections (26%), followed by fungal infections (22%), acanthosis nigricans (20%), diabetic foot (16%), nail changes (16%), acrochordons (10%), diabetic dermopathy (9%), necrobiosis lipoidica (9%), viral infections (8%) pruritus (8%) and xanthelasma (8%). There was significant association of unsatisfactory glycemic control with bacterial infections ( p = 0.037) and fungal infections ( p = 0.023).  Females especially had a higher frequency of association with acanthosis nigricans ( p = 0.030). Conclusion Patients with type 2 DM have high frequency of infections especially bacterial and fungal. Other manifestations like acanthosis nigricans and diabetic foot are comparatively less common.