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At some point in their lives, about 1 in 3 people with diabetes will develop a skin disorder related to their condition. Just a few factors take the blame for most diabetes-related skin problems, including nerve damage, poor circulation due to damaged blood vessels, high blood glucose levels, and reactions to the pokes and jabs from insulin injections or home blood glucose testing.

Nerve damage interrupts the messages your skin sends when it's in danger from infection, injury, or excessive dryness. It also decreases your body's sweat output, which can leave skin overly dry. Damaged blood vessels causing poor circulation deprives the skin of oxygen and can lead to ulcers, infections, and wounds that heal slowly. Changes in blood flow can also cause a condition called necrobiosis lipoidica diabeticorum, leading to yellow, waxy, and raised skin that is often lined with a purple border.

When blood glucose levels are high, the body tries to flush out some of the glucose through the urine. In this way, your skin loses precious fluids that it needs to keep the skin healthy and moisturized. Skin that becomes very dry can crack and peel and leave a person vulnerable to bacterial and fungal infections that may be severe and slow to heal. Germs can also enter through cracks in the skin and feed off glucose-rich blood, making infection more likely to occur.

Life with diabetes can be filled with many pokes and injections. Daily blood glucose tests require tiny pin-pricks to the skin, and the skin can become irritated. Rarely, insulin injections spark allergic reactions with pain, burning, redness, itchiness, and swelling around the injection site. Some people are even allergic to the adhesives, tapes, and wipes that are used to prepare skin for injections or to hold insulin pumps in place. More common are the fatty deposits (lipohypertrophy) that can develop beneath the skin on the spots where insulin is repeatedly injected, making the skin appear lumpy or indented. To avoid these deposits, switch up injection sites from day to day.

Tips for skin care

  • Control your blood glucose level. It is not always easy, but maintaining a healthy balance in your blood glucose could work wonders for your skin.
  • Wash and dry. Keep your skin clean by washing in warm water and using mild soap. Gently pat-dry your skin, paying extra attention to places where water can hide - under arms, under breasts, between legs, or between toes. Make quick "skin scans" a part of your shower routine. Limit bathing and using hot water, as they strip the skin of oils and make skin even drier. Check your feet every day for small cuts or scrapes that can often go unnoticed. Take care when clipping toenails.
  • Moisturize. Massage lotion or moisturizer into your skin after washing. Don't skimp on dry-patch-prone spots like elbows, knees, and heels.
  • Chafe-proof your skin. Pat non-medicated talcum powder onto any areas where skin touches skin, such as between the thighs.
  • Stay hydrated. This is good skin care advice for everyone! Drink lots of fluids to keep your skin supple.
  • Dress the part. Wear breathable materials, especially on areas prone to moisture.
  • Humidify your home. During the winter months, use a humidifier to moisten the air dried out by radiators and forced heating.
  • Protect your skin from the sun. While this is true for everyone, wearing sunscreen will protect your skin from the burning and blistering that can lead to dangerous infections.
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