Dermatological manifestations in diabetes mellitus and its relation with HbA1c levels – An observational study

Diabetes Mellitus is a chronic, metabolic disease characterised by elevated levels of blood glucose, which over time leads to serious damage. The most common is type 2 diabetes which occurs when body becomes resistant to insulin or doesn’t make enough insulin. Skin manifestations are seen generally in pre-diabetes, undiagnosed, long-term and uncontrolled diabetes mellitus. Skin symptoms may help in diagnosing a denovo case and may give an insight into the patient's diabetic status. This is a cross-sectional, observational study conducted in patients attending the outpatient departments of Dermatology, General Medicine and those admitted under these departments over a period of four months. Clearance from Institutional Ethics Committee was taken before the start of the study. A sample population of 100 was selected randomly based on inclusion and exclusion criteria. Glycaemic profiles including HbA1c were done. Infections (35%) were the most common cutaneous symptoms, followed by papulosquamous illnesses (19%), autoimmune diseases (7%), obesity-related (6%), diabetic vasculopathy-related (5%) and miscellaneous conditions (28%), which included generalised pruritus and xerosis etc. The majority of infections were superficial fungal infections, followed by bacterial and viral infections. Dermatophytosis accounted for a majority of superficial fungal infections. Significant correlation was found between higher HbA1c levels and infections, papulo-squamous diseases, auto-immune diseases, obesity-related manifestations. Higher HbA1c levels were found to be significantly associated with a variety of cutaneous symptoms such as infections, papulosquamous illnesses, autoimmune disorders, and obesity-related manifestations.