The Correlation between Skin Lesions, Microalbuminuria and other Microvascular Complications in Type 2 Diabetic Patients

Background and Aims: Patients with diabetes mellitus commonly suffer from a wide variety of cutaneous disorders. Clinical manifestations and complications of skin diseases are more common and severe in these patients. Some skin disorders are more prevalent in patients with microvascular complications. The aim of this study was to evaluate the correlation between skin lesions in type 2 diabetic patients and microvascular complications.

Methods: In this study, 1135 type-2 diabetic patients were included and examined by a dermatologist for diabetes mellitus related skin lesions, skin infections and cutaneous manifestations due to treatment. Smear, culture and biopsy of the lesions were done for definite diagnosis. Retinopathy, neuropathy and nephropathy were evaluated in all the patients.

Results: The mean age of study population was 54±11 years; 619 (55%) female and 516 (45%) male. Mean duration of disease was 9±7 years and HbA1c was 7.8±1.6. Prevalence of skin lesions was 64% (95% CI: 61.2-66.8). Of all micro vascular complications, only neuropathy had a strong association with diabetes mellitus-related skin lesions with an odds ratio of 1.9 (95% CI: 1.5-2.5). Only eight percent of the skin manifestations had developed in less than one year after diagnosis of diabetes mellitus. The prevalence of neuropathy and albuminuria was significantly higher in patients with tinea pedis. The prevalence of neuropathy was significantly higher in patients with facial erythema, pyoderma, tinea pedis, nail dermatophytosis, candidial paronychia and itching.

In patients with diabetic dermopathy and foot ulcer, the prevalence of retinopathy, neuropathy, albuminuria, mean age, duration of diabetes and percentage of insulin users were significantly higher than those without such lesions. Conclusions: This study shows that skin lesions are common in patients with type-2 diabetes mellitus. Some of cutaneous manifestations are indicative of microvascular complications and patients with these skin manifestations should be evaluated for microvascular complications.