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Diabetes: The Bitter Effects on Your Skin

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Diabetes: The Bitter Effects on Your Skin
Emily Jorge, DCNP
Diabetes: The Bitter Effects on Your Skin

The Centers for Disease Control and Prevention (CDC) has listed some fast facts about diabetes.

By Emily Jorge, DCNP, FNP-BC

The Centers for Disease Control and Prevention (CDC) has listed some fast facts about diabetes.  Let’s take a look:

  • In 2012, diabetes and its related complications accounted for $245 billion in total medical costs and lost work and wages
  • 1.7 million people aged 20 years or older were newly diagnosed with diabetes in 2012.
  • Non-Hispanic black, Hispanic, and American Indian/Alaska Native adults are about twice as likely to have diagnosed diabetes as non-Hispanic white adults.
  • 208,000 people younger than 20 years have been diagnosed with diabetes (type 1 or type 2).
  • 86 million adults aged 20 years and older have prediabetes.
  • The percentage of U.S. adults with prediabetes is similar for non-Hispanic whites (35 percent), non-Hispanic blacks (39 percent), and Hispanics (38 percent).

According to the CDC, twenty nine million people in the United States suffer from diabetes mellitus* and up to 30% of people who suffer from this chronic disease will have some form of skin disorder.**  Many of these individuals are familiar with terms such as “hemoglobin A1C, sliding scale, or insulin,” but may need to familiarize themselves with more diabetic monikers.

Necrobiosis Lipoidica Diabeticorum:  Three-quarters of patients with diabetes mellitus will experience these waxy, yellow-brown plaques, particularly in those who are insulin dependent. Located primarily on the shins, ulceration can occur in up to one-third of people and may be caused by the small vessel disease associated with diabetes.** Treatment can be challenging, but protecting the affected areas is essential.

Diabetic Dermopathy: This also typically occurs on the shins but presents as multiple circular patches.  Some may be scaly, others may look more like a scar.  These lesions can persist despite treatment and requires protection from trauma or infection.

Diabetic Bullae:  This is characterized by large blisters often found on the lateral and dorsal surfaces of the lower legs and feet.  Most patients describe having very little or no symptoms associated with this and don’t recall any trauma to the area(s).  Treatment is supportive and scarring is rare.

Acanthosis Nigracans:  Brown, velvety plaques and patches erupt in a pattern primarily involving skin folds.  It is not always associated with diabetes mellitus.  It can be found in the obese, those who may have a malignancy or insulin resistance, or it can be familial.  Sometimes topical emollients may work such as retinoids or AmLactin lotion, but these can be disappointing.  Treating the underlying condition may ameliorate some of the discoloration.

Scleredema Diabeticorum:  Found more commonly in obese, middle aged men who are insulin dependent, this rare disorder is described as an induration of the skin mostly found on the upper back or neck. Control of the hyperglycemia does not influence the skin in this circumstance. Treatment has had mixed results.

References:

* Centers for Disease Control and Prevention (CDC). (2014, June).  Diabetes Latest. Retrieved December 4, 2016 from https://www.cdc.gov/features/diabetesfactsheet/

** Mancini, Anthony J., & Paller, Amy S. (2016).  Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (5th ed.) (pp 552-553)Toronto, Canada: Elsevier

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Emily Jorge, DCNP

Emily Jorge is a Certified Dermatology Nurse Practitioner (DCNP) who holds certifications from the Board Certified American Nurses Credentialing Center (ANCC) and the Dermatology Nursing Certification Board (DNCB). She also belongs to the National Academy of Dermatology Nurse Practitioners (NADNP), the Dermatology Nurses’ Association (DNA), and Chattanooga Area Nurses in Advanced Practice (CANAP).

She received her Master’s Degree Nurse Practitioner from Southern Adventist University. She practiced as an aesthetician/nurse in the field of dermatology from 2005 to 2011. Since 2012, as a dermatology certified nurse practitioner, she has focused on diagnosis and treatment of skin, hair, and nail diseases as well as the surgical aspects of dermatology. She is a preceptor for students interested in dermatology from area universities/colleges.

Emily is involved in a church plant in Chattanooga and serves as a volunteer for It Is Written. She also volunteers for the AMEN free clinics in Chattanooga, which offer free dental care, general medical care, and health education services to the uninsured and underinsured.

Emily Jorge, DCNP is now accepting patients in Dalton & Calhoun, GA.

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