Cutaneous manifestations in diabetes mellitus: A study among 500 patients in a tertiary care center in South India

Abstract

Introduction and Objectives: Mucocutaneous manifestations are seen at one or the other time in diabetes mellitus. The frequency and type of manifestation may be related to the glycemic control and duration of diabetes. This study was conducted to find the hospital based prevalence of mucocutaneous manifestations in patients with diabetes mellitus, their clinical pattern and relationship with glycemic control and duration of the disease. Materials and Methods: Five hundred consecutive patients with diabetes mellitus attending medicine and dermatology OPD were included. Detailed history, clinical examination and investigations were done. Those with gestational diabetes, HIV, internal malignancy, other terminal illnesses and steroid-induced hyperglycemia were excluded. Results: Male to female ratio was 1.63:1. Mucocutaneous manifestations were present in 414(82.6%) patients. Among the various cutaneous manifestations, majority were the dermatoses commonly associated with diabetes, 254(50.8%), followed by cutaneous infections, 219(43.8%). Among the cutaneous infections, fungal infections, 165(33%) were the commonest. There was a statistically significant (p < 0.05) increase in cutaneous manifestations in patients who had poor glycemic control compared to good and moderate control. Cutaneous manifestations were more common in patients with diabetes of more than 5 years duration and was statistically significant. Conclusion: Mucocutaneous involvement is common among patients with diabetes mellitus, especially in poorly controlled disease. Cutaneous manifestations increase with the duration of the diabetes. Proper skin care and long-term control of blood glucose levels may reduce the risk of development of some of the skin lesions and improve the quality of life in diabetic subjects.