A statistical analysis of diabetics in the United States has shown that up to one third of the patients with diabetes have or have had some type of skin disorder. Hypoglycemia can affect the skin, because the skin cells do not get the required amount of glucose. Whenever administration of insulin exceeds the amount needed for the metabolism of ingested carbohydrates, a diabetic can experience hypoglycemia.
Hyperglycemia can also cause skin disorders. Hyperglycemia changes the nature of the skin environment. Normally, bacteria in the air do not want to reside on the surface of the skin. The veracity of that statement changes whenever the skin gets an added amount of glucose. The extra glucose in the blood of a diabetic can make a once forbidding section of skin seem like the ideal place for bacteria or some other group of microbes to grow.
The term “skin disorders” does not refer to wrinkles or folds in the skin. An aging diabetic can expect to get some wrinkles. A once obese diabetic who has lost a great deal of weight can expect to have some folds in his or her skin. The term “skin disorders” refers to changes in the integrity of the skin.
Sometimes changes to the integrity of the skin can lead to alterations in the skin pigmentation. Sometimes an area of hyper-pigmentation can be associated with a skin lesion. By examining such a lesion, a physician can better tell whether or not it should be seen as a symptom of diabetes. The next paragraphs explain what the doctor checks for.
First, the doctor notes the location of the lesion. Is it on a bony surface? Is it somewhere where the bone rises above the level of the adjoining body parts? Diabetics often develop a lesion on the prominent bones of the back or the bones on the feet. Those are regions where the skin might feel particular stimuli—heat, cold or pressure from blunt objects.
Next the doctor studies the appearance of the lesion. Is it round or oval? Does it have reddish or brown color? Is the skin in the lesion scaly? If the answer to all three questions is “yes,” then the doctor has good reason to view the lesion as a symptom of diabetes.
Of course not every diabetic who has a skin disorder has a lesion such as the one described above. Some diabetics develop what is called Acanthosis Nigricans (AN).
A diabetes patient with AN will arrive at a doctor’s office with dark, velvet-like patches on parts of his or her skin. Those patches normally form on the back or the neck.
Unlike the other skin disorders, AN can not be viewed as an “equal opportunity disorder.” The percentage of diabetics with AN rises markedly among Hispanics, African Americans and Native Americans. While not all diabetics have the same chance for developing AN, all patients who have AN appear to have some type of insulin resistance.
The other skin disorders most often associated with diabetes are infections. An infection develops when the body attempts to destroy an invader, usually a microbe. Bacteria and fungi are the two types of microbes that have been shown to take advantage of any opportunity to grow and to reproduce in the body of a patient with diabetes.
Although one-celled organisms, bacteria are the most abundant and the most pathogenic of all the known microorganisms. Not all bacteria harm the body. Some bacteria perform useful functions within a healthy body. Other bacteria, what might be called “bad” bacteria, release harmful chemicals. Some of those chemicals digest body cells, and other chemicals disrupt specific body functions, causing disease, and sometimes death.
Bacteria find the high glucose levels in the blood of a diabetic to be an excellent source of food. A physician can expect to see some of his or her diabetic patients present with a stye. A stye is a bacterial infection in the glands of the eyelid.
Not all bacteria choose to grow in the glands of the eye. Some bacteria take up residence in area of the skin that holds a hair follicle. When bacteria grow around the hair follicle of a diabetic, their growth can lead to formation of a boil.
While no bacterium has more than one cell, a fungus can be either a one-celled or a multi-celled organism. Some of those cells form thread-like fibers. Other cells form spores, the structures that allow fungi to reproduce. When fungi have access to an inviting environment, they ramp-up the rate of their reproduction.
The fungal infections that most often complicate the life of a diabetic are those caused by contact with a fungi-infested surface. A diabetic who wants to participate in sports should know that many such surfaces exist in the typical locker room. The fungus that causes jock itch awaits contact with a warm body. Hiding there on apparel in the locker room, that fungus welcomes contact with a glucose-laden body. The fungus that causes athletes’ foot can grow on shower walls in a locker room that wasn’t well sanitized.
While male diabetics usually need to be concerned about the above-mentioned fungal infections, female diabetics need to watch for evidence of a different sort of fungal infection. Female diabetics can develop yeast infections. Such infections are usually vaginal infections.
In order to understand the nature of vaginal infections, one must recall the earlier mention of “good” bacteria, bacteria that perform a useful function in the human body. Some bacteria normally prevent fungi from growing in the vaginal area. Yet the body has a fixed amount of bacteria. If those bacteria can not reproduce as rapidly as the fungi, then the fungi take over.
That is what happens in the female diabetic. The high glucose levels in the blood spur the growth of fungi in the vaginal area. The woman then develops a vaginal infection.
All infections, both those caused by bacteria and those caused by fungi, are treatable. The infected diabetic must consult with his or her physician.