Test Your Knowledge

People with diabetes are more likely to suffer skin conditions for many reasons. Diabetes involves or increases the likelihood of risk factors including:

• Impaired circulation. Reduced blood flow delays recovery because the infection–fighting white blood cells cannot travel as well. One cause of impaired circulation that is common with diabetes is atherosclerosis (hardening or narrowing of the arteries). Diabetic skin disorders in which impaired circulation can be a factor include bacterial and fungal infections, cellulitis, diabetic dermopathy, diabetic sclerosis, necrobiosis lipoidica diabeticorum (NLD) and pruritus.
  
  
• Suppressed immune system. Impaired ability of white blood cells to fight infections results from the impaired circulation and high glucose (blood sugar) levels common in diabetes. Diabetic skin disorders in which a suppressed immune system can be a factor include bacterial and fungal infections, cellulitis and pruritus.
  
  
• Hyperglycemia. High blood sugar feeds disease–causing microbes and reduces the ability to fight infection. It also causes the body to lose fluid, allowing the skin to dry, crack and let in infectious organisms. Diabetic skin disorders in which poor control of glucose can be a factor include bacterial and fungal infections, acanthosis nigricans, diabetic blisters, diabetic sclerosis, scleroderma diabeticorum, eruptive xanthomatosis, NLD and pruritus.
  
  
• Diabetic neuropathy. Damage to the autonomic nerves (those controlling involuntary functions) makes the body sweat less. Reduced perspiration dries the skin and makes it more likely to crack and allow infections to enter. Damage to the peripheral nerves serving the limbs impairs sensation and increases the risk of foot cuts and other injuries. Diabetic skin disorders in which nerve damage can be a factor include bacterial and fungal infections, cellulitis, diabetic blisters and pruritus.
  

  

• Hyperlipidemia. Unhealthy amounts of cholesterol and other fats in the blood not only boost the risk of heart attack, stroke and other life–threatening conditions, they can also contribute to skin problems. Eating trans fat and saturated fat contributes to atherosclerosis and can impair circulation. Diabetic skin disorders in which hyperlipidemia can be a factor include acanthosis nigricans, eruptive xanthomatosis and NLD.

• High blood pressure. Hypertension can worsen the above risk factors. For more information, see Blood Pressure & Diabetes.