Skin Lesions in Type 2 Diabetes

OBJECTIVE: The aim of this study was to determine the frequency of skin lesions in type 2 diabetes patients. PATIENTS AND METHODS: A cross-sectional study was conducted at Muhammad Medical College Hospital Mirpukhas, Sindh from July 2008 to December 2009. The sample size comprised of 1270 type 2 diabetes patients. The patients were examined by a physician to determine the presence of diabetes mellitus-related skin lesions, skin infections and skin lesions caused by treatment. The data were collected on preformed proforma. Age, sex, duration of diabetes, mode of treatment, whether on oral hypoglycemic agents or insulin were noted. A multivariate logistic regression model was used to estimate the adjusted odds ratio (OR) for having diabetes related skin lesions. All data was analyzed by SPSS-10.0 for Windows (Chicago, IL. USA). The chi-square and student t-test were used as test of significance for qualitative and quantitative variables respectively. A p-value of <0.05 was considered statistically significant. RESULTS: The mean age of patients was 52±11 years, 768 (60.47%) were female and 502 (39.62%) were male. The mean duration of the diabetes was 19±7 years and mean HbAlc was 11.8±3g/dl. Oral hypoglycemic agents were used by 913 (81.88%) patients, insulin by 164 (12.91%) and both were used by 193 (15.19%). The skin lesions were observed 851 (67%). The most common lesion was diabetic dermopathy (28.34%), but different types of skin infections were seen in 42.6% of patients and thus forming the most common lesion. The third most common manifestation was pruritis (28.05%) and the least common was the perforating dermatoses (0.78%). The HbA1c was higher in patients suffering from diabetic foot ulcer and fungal infection than those without having these infections (10.34±1.67 and 11.5±1.4 vs.9.7±1.6 and 8.9±1.6, respectively) (p<0.05). CONCLUSION: This study shows that skin lesions are common in patients with type 2 diabetes mellitus. Therefore, frequent skin evaluation of the diabetic patients is warranted.