2. A and C. Nephropathy (kidney damage) can cause pruritus, or itching. The skin may be dry and itchy, but with no visible rash, as a result of elevated proteins and enzymes in the blood.
Peripheral vascular disease (PVD) — damage to the blood vessels, most often in the legs — can cause decreased hair growth and “staining” of the skin, or brown patches, on the lower legs and tops of the feet, along with swelling, dryness, and decreased sensation.
High blood pressure can lead to peripheral vascular disease, but does not itself cause skin changes.
Retinopathy does not cause skin problems.
3. A, B, C, and E. Neuropathy (nerve damage) is perhaps best known for causing decreased sensation (numbness) and/or pain in the feet and legs and sometimes hands and arms, but it can have other consequences as well. Nerves are required to stimulate the production of sweat, so you may notice decreased sweating all over your body. This can also cause skin to become cracked and dry. Decreased sensation as a result of neuropathy can contribute to the development of ulcers when cuts, sores, or friction that would normally be painful or irritating go unnoticed. Simply wearing an ill-fitting shoe that rubs on the foot can create a sore that can become an ulcer.
Hives are not related to neuropathy.
4. A, C, and D. Diabetic dermopathy produces clusters of small, round, pink spots that appear on the shins and quickly turn brown and scaly. The spots are painless and may eventually disappear without treatment, but they often leave permanent pigmentation changes.
Bacteria on the skin grow more rapidly in the presence of high blood glucose and can progress deeper into the tissue beneath the skin, causing cellulitis or even sepsis (blood infection). Other bacterial infections that occur with great frequency in people with diabetes are styes (infections of the glands of the eyelid), folliculitis (infections of the hair follicles), boils, and infections around the nails.
Acanthosis nigricans appears as velvety dark plaques around the neck and underarms and other skin folds, or on the face and knuckles. The skin becomes darker because it is thickened by insulin and other growth factors that are elevated in people with Type 2 diabetes. Weight loss, as well as keeping blood glucose in the target range, may improve this condition.
Acne is not related to high blood glucose.
5. A, B, C, and D. Good hygiene is important for everyone. You do not need harsh antibacterial soaps to be clean. Instead, use gentle, additive-free cleansers, and moisturize daily. People with diabetes can be more prone to allergies to additives such as dyes and fragrances. Keeping your blood glucose in the target range helps reduce the chance of infections and can prevent skin changes related to nerve and blood vessel damage (as described in Question 2). Following a healthy diet is good for every organ, including the skin. The vitamins, minerals, and proteins in a balanced diet are required for maintaining healthy skin and especially for repairing injured skin.
