People with either type of diabetes are more likely to suffer from a number of skin conditions, which can be serious.
There are two types of diabetes . In both, the absence or insufficiency of insulin causes the glucose to not enter the cells and the sugar is left out, left in the circulation. “Insulin is very important for the skin because it helps, for example, the growth of the keracinocytes, the skin cells,” explains dermatologist Flávia Ravelli, from São Paulo. With the growth of damaged keracinocytes, the cutis loses thickness and elasticity, thus becoming thinner and elastic.
The truth is that the high glycemic rate has several consequences for the skin, as Flavia and the endocrinologist Denise Reis Franco of São Paulo explain.
High glycemia causes an inflammatory reaction in the blood vessels. “While in large vessels the possible consequence of this inflammation is cardiovascular disease, in the case of small vessels, which nourish the skin, it impairs irrigation,” explains Denise. Thus, wound healing is slower.
Loss of sensitivity
The nerves, soaked in glucose and without adequate blood supply, become softer and do not work perfectly. The effect is the loss of some of the skin’s sensitivity, as well as generalized itching and the sensation of needling (as if the skin was being spiked).
“In diabetic, the immune system does not work properly, which increases the chance of infections,” says Flavia. They can be caused by both bacteria and fungi, as is the case of mycoses and chilblains.
When the body fails to generate insulin, it paradoxically begins to produce a substance called insulin growth factor. It causes acanthosis nigricans, a skin disease in which the regions of folds, such as the neck and underarms, become darkened.
The barrier function to prevent loss of water by the body does not work properly in the diabetic. The result is dehydrated skin prone to dermatitis.
“People suffering from type 1 diabetes are more likely to develop another autoimmune problem,” says Denise. This is the case of vitiligo, a skin disease in which the body itself attacks the pigmentation cells, causing white patches on the body.
The diabetic’s skin, therefore, is more prone to suffer lesions and infections of all kinds. The combination of this factor with another, poor skin sensitivity, can culminate in a very serious problem: the diabetic foot. “A simple stone in the shoe can hurt the skin and the person does not perceive because it has little sensitivity in the extremities,” explains Flavia. “The lesion evolves into an infection and as the skin does not receive enough irrigation to recover the injured tissue, the infection progresses until it reaches muscle, fat and even the bones.” When the situation gets to that point, the foot needs to be amputated so the infection does not spread through the body.
How to prevent
Examine the skin
The main prevention measure is to examine the skin, especially the feet, in the morning and at night. Look for mycoses between the fingers, small lesions and body wounds, and if you find them, go to the doctor as soon as possible.
Drink plenty of water and use moisturizer
get to the skin every day to prevent dehydration. “A good daily ritual is to wash your feet with soap and water, dry them well and spread hypoallergenic, unscented and dermatologically tested moisturizer. With this procedure, the diabetic will end up doing the inspection of the skin, “suggests Flavia.-diabetes
Take care of the shoes
Wear comfortable shoes, preferably those specially made for diabetics. Before putting on shoes, check each person for stones or any change in the insole that could hurt the soles of the feet.-diabetes
Find a Podiatrist
If possible, hire a specialized nail clipper service. A simple cut or “steak” taken out during the process can lead to infection.