Understand my skin

Diabetes and how it affects skin and feet

Diabetes is an increasingly prevalent disease around the world. It has far-reaching effects on overall health, including causing complications in the skin, on body and on feet. Properly monitoring and caring for these complications can have an important and positive impact on diabetics’ daily life.

In a healthy body, the pancreas regulates the amount of glucose, or sugar, in the blood stream with insulin. This hormone helps glucose pass into the body’s muscles, where it’s burned. With diabetes, one of two things happens. Either the pancreas stops producing insulin, or the body’s cells gradually resist insulin’s action. Without insulin, glucose stays in the bloodstream, creating chronic hyperglycaemia. This affects many of the body’s organs in different – and not usually very good – ways. Two types of diabetes exist:

Type 1 diabetes is an autoimmune disease that develops because the pancreas stops producing insulin
It most often occurs, but not always, in children and young adults

Treatment consists of injecting insulin to make up for what the pancreas no longer provides

Type 2 diabetes is a metabolic disease that develops gradually. The body becomes resistant to insulin and the pancreas’ ability to secrete insulin weakens.
Adults over 40 tend to be more affected, brought on by an unbalanced diet and a sedentary lifestyle, among other factors
Treatment includes changes in diet, exercise, medication and insulin
92% of diabetic people in France are Type 2, and there are more people every year

Around the world, 463 million adults live with diabetes today, which is expected to rise to 700 million in 2045¹

Both types of diabetes show high levels of glucose in the blood at diagnosis
Both types require constant glucose monitoring
Serious complications can arise in various parts of the body, including skin, if the disease is not managed properly
Other factors can affect the complications, such as a patient’s age, how long they’ve had diabetes, and lifestyle

¹https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html, consulted 10/03/21

Autoimmune vs Metabolic Diseases: what’s the difference?

An autoimmune disease is when the body’s own immune system attacks and destroys healthy body tissue by mistake. It is the case for type 1.

A metabolic disease is when normal metabolism processes stop functioning and the body has either too much or too little of the substances that it needs to stay healthy.

This is the case for Type 2 diabetes.

Skin is the body’s largest organ, and therefore directly impacted by chronic hyperglycaemia. Sweat and sebum glands, nerves and arteries can all be affected, and the skin can suffer in different ways.

Diabetes’ effect on skin can therefore be far-reaching. It’s possible that the skin’s sweat and sebum glands secrete less. This can lead to dry and very dry skin. Particularly in feet, extra thick skin – hyperkeratosis – may also develop. When chemical reactions in nerve endings create nerve damage, muscles in the foot may atrophy, leading to deformations such as a flat foot or hammer toes. Feet or a part of the foot may lose all sensation. When arteries are affected, blood no longer flows correctly, depriving areas of the body of oxygen, which is required for proper healing.

Xerosis is one example of a skin complication due to diabetes. With a high glycaemic index, diabetics’ blood circulation is affected, which can prevent skin from sloughing off and renewing itself normally. Patients develop dry, flaking skin that affects all parts of the body, including the scalp. The flakes collect at the skin’s surface, becoming itchy and irritated. Skin thins and becomes fragile and sensitive to the slightest irritation. Cold temperatures and dry air can further exacerbate feelings of itchiness and discomfort. About 30% of diabetics have xerosis, and it’s more common among patients with Type 2.

While monitoring the level of glucose in their blood is the most important part of a diabetic’s care routine, patients can provide additional care for their skin in a number of ways.

Below are specific suggestions to alleviate skin complications, and keep them to a minimum.

Find out as much as you can, as early as you can, about monitoring your feet. For example, keep an eye on any warning signs whether it is the apparition of corns or callouses and pay particular attention to loss of sensitivity. In this case, consult your chiropodist.
The health of your feet should determine how frequently you visit your chiropodist, from one to up to four times a year or more if ulcers develop.
Learn how to care for your nails and toes. Your chiropodist can show you how to cut nails and prevent deformations from developing.
It’s better to not walk barefoot, however, to avoid developing any scratches that may have difficulty healing.
Wear loose clothing and wide comfortable shoes with cotton socks. You can also leave your feet in the open air.
Wash at warm temperature, not too hot. Use a gentle cleanser, and dry carefully, not letting any water stay in skin folds or between toes.
Apply an emollient 1-2 times a day after washing while being careful to avoid spaces between toes. This provides an excellent opportunity to closely examine your feet at same time.