Dermatological lesions in diabetes

Diabetes is a chronic metabolic disease characterised by high glucose levels and altered carbohydrate and lipid metabolism, affecting an increasing number of people worldwide. Spain ranks fifth among European countries with the highest incidence of diabetes. Hyperglycaemia causes damage to numerous cell types, including keratinocytes and fibroblasts in the skin. Dermatological manifestations appear in more than 30% of cases of diabetes at the onset of the disease and in up to 100% during the course of the disease. This makes skin examination of patients particularly important, as early treatment of diabetes can slow the progression of the disease and improve its prognosis. In addition, some dermatological changes may alert us to suboptimal metabolic control of previously known diabetes. Some lesions are associated with insulin resistance, others are due to fungal or bacterial infections, there are also alterations due to diabetes itself or to chronic complications of diabetes; finally, there are lesions due to pharmacological treatment of the disease and to devices such as insulin infusion pumps and sensors for interstitial glucose measurement. Knowing and recognising dermatological changes is therefore essential in our daily work, because they guide us towards a better management of the disease and its causes.