This powerpoint is enclosed with information on Diabetes and Skin care as well as how sleep affects skin care. Diabetes is one of the most common medical conditions patients have. The risk factors of diabetes are family history, ethnicity (asian, hispanic, african american), obesity, lifestyle factors (exercise, smoking, diet, alcohol). The skin related hormones are HLA, melatonin, prolactin, estrogen, testosterone, and thyroid hormones. Some complications of diabetes are macrovascular and microvascular complications. The microvascular complications are retinopathy, nephropathy and neuropathy. Neuropathy is when there is a loss of function in your lower extremities due to the complication of the diseased state, which in this case is diabetes. To prevent complications of diabetic neuropathy, it requires taking great care of your feet. Some measures patients can take to make sure to wash their feet everyday, check the feet everyday to ensure there aren't any cuts or infections. Patients should also trim their nails to keep their feet clean. Along with doing all these things at home, patients are also advised to visit the podiatrist once a year for a regular physical foot exam to see if there is any loss of sensation on their feet.
Other skin complications of diabetes are diabetic dermopathy, diabetic blisters, digital sclerosis, etc. Diabetic dermopathy is when patients have dark brown scaly patches, which occurs from the changes in small blood vessels due to the diabetes itself. However, they are not harmful and no treatment is needed for this condition. Digital sclerosis is when patients develop thick waxy skin on the back of their hands. This happens due to the uncontrolled blood sugar levels and the only treatment for this condition is to bring down the sugar levels within range. Some ways to take care of your skin when you have diabetes is avoid very hot showers or baths. Make sure to keep the skin dry and clean. Dry skin can lead to itching which can cause scraping and cause infections. Therefore keep the skin moisturized. These are some ways to prevent skin complications, however, if these methods aren’t working, make sure to contact your doctor to get help.
References:
Diabetes and Your Feet. (2019, December 4). Retrieved from https://www.cdc.gov/diabetes/library/features/healthy-feet.html
Skin Complications. https://www.diabetes.org/diabetes/complications/skin-complications.
Diabetes mellitus is one of the leading causes of death in the United States and is a contributing comorbidity to increasing mortality. Diabetes is a metabolic disease where the pancreas does not produce enough insulin or can not use insulin appropriately. Type 1 diabetes is an autoimmune disease where the body destroys insulin-producing pancreatic beta cells. In type 2 diabetes, the pancreas cannot produce enough insulin to take in sugar and patients become resistant to insulin. Uncontrolled diabetes produces life-threatening symptoms and increases mortality.
One of the leading chronic complications of uncontrolled diabetes is diabetic foot ulcers, followed by retinopathy, then nephropathy. Nearly a quarter of diabetes patients may develop a foot ulcer at some stage of their diagnosis. A diabetic foot ulcer is an open sore or wound occurring on the foot. The formation of diabetic foot ulcers is complex. Initial stages include tingling sensations and numbness which many patients overlook. Reduced blood flow and duration and diabetes play the biggest roles in the deteriorating condition. Other external factors such as trauma, dryness of the skin, cracks, and any foot deformities such as hammer toes and bunions further trigger the potential of an infection on the foot. It is essential to seek care from a podiatrist to address such concerns and reduce the risk of amputation.
Preventative care is the first-line treatment for diabetic foot ulcers. Managing blood glucose levels and frequently cleaning any wounds on the foot are vital in infection prevention. It is ideal to not apply pressure to the bottom of the foot, the most common area of ulcers. During the healing period, patients may walk with special footgear or simply reduce walking until the ulcer has healed. Appropriate footwear should be researched as wider shoes are now being sold and tight shoes can further aggravate any injuries. Orthotic shoes are also available on the market and have shown promising benefits. Wound management includes frequently applying dressings and topical medications. As a diabetic, wound healing takes longer than a nondiabetic, which is why it is important to continue following up with your endocrinologist or primary care physician.
With dryness and cracking being a triggering factor in foot ulcers, patients can use over-the-counter and non-medicated products to alleviate the dryness. Products such as Vaseline and heavy creams can provide minimal benefits. Ammonium lactate is commonly prescribed to keep the foot moisturized and is available as a low-cost generic. It is also available over-the-counter as the brand AmLactin. A prescription alternative to petrolatum jelly is Santyl, a collagenase ointment used in healing damaged tissue from chronic skin ulcers and burns. In cases of severe diabetic foot ulcers that require hospital intervention, oral or intravenous antibiotics are used depending on the involvement of the joint or bone and the size of the wound. Patients should be educated on preventative measures such as wound care and glycemic control to prevent extensive complications such as amputation and numbness in the feet.
References
https://www.who.int/news-room/fact-sheets/detail/diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664939/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791567/