A Tertiary Care Hospital-based Study of Various Skin Manifestations in Diabetes Mellitus Patients: Skin as a Clinical Marker of Diabetes Mellitus

Introduction: Incidence of skin manifestations in diabetes mellitus (DM) varies from 11.3 to 70.6% and may manifest once the primary disease has already developed, but may also occur coincidently with its onset or may even precede DM in some of the cases. Our study is an attempt to analyze the pattern of various types of skin manifestations seen in DM. Aims and objectives: To study and analyze the various skin manifestations in patients of DM. Materials and methods: Two hundred patients of DM were enrolled. A detailed history was taken, investigations like preprandial and postprandial capillary plasma glucose and HbA1c were done. Diabetes was considered controlled when preprandial capillary plasma glucose 3.9–7.2 mmol/L (70–130 mg/dL), postprandial capillary plasma glucose < 180 mg/dL, and HbA1c < 7.0%. Results: Infections were the commonest skin manifestation present in a total of 81% of patients (56% fungal, 19% bacterial, and 6% viral) followed by conditions associated with DM present in 67% of patients (skin tag 33% was the commonest). Miscellaneous skin conditions were present in 62% of patients (discoloration of nails was the commonest 11%). Conclusion: Various skin manifestations may appear early and remain undetected till DM is diagnosed. The majority of patients do not take regular treatment and follow dietary restrictions in early diabetes leading to a persistent hyperglycemic state which predisposes to infections and other skin manifestations. The presence of easily visible skin manifestations can heighten the suspicion for early diagnosis of DM and thus, may very well be taken as a clinical marker of DM.