Zhao Min Xie Yanli, Characteristic Medical Center (formerly 306 Hospital), Department 1 and 4 of Special Service Diagnosis and Treatment
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center
Diabetes mellitus is a common geriatric disease, due to the aging of various tissues and organs of the elderly, low immune function, and the long-term hyperglycemia state of the body will lead to lesions of nerve endings and microvessels, so that the distal limbs will have sensory impairment, and the skin will appear hypoxia, ischemia and other abnormal states, so diabetic patients are more prone to skin problems. As a long-term diabetic patient, how can I improve the skin problems caused by diabetes?
Diabetics are prone to skin diseases
(1) Skin infection: mainly bacterial, fungal and viral infection. The high sugar environment in the sugar friends, combined with a weakened immune system, provides opportunities for fungal, bacterial and viral invasion and multiplication, with fungal infections being the most common.
(1) Fungal infection: It can cause ringworm of the hand, athlete's foot, onychomycosis, jock itch, tinea corporis, oral cavity and vulvar Candida albicans infection, etc. The common ringworm of the hands and feet is manifested as a rash, scaling, and itching on the skin, and Candida albicans infection in women infected with fungi can also cause vaginitis, with vulvar itching and increased discharge.
(2) Bacterial infection: the most common is Staphylococcus aureus, which can cause skin boils, carbuncles, folliculitis, hidradenitis, etc. Folliculitis is more common on the head, face and buttocks.
(3) Viral infection: herpes zoster and herpes simplex are the most common, mainly manifested as pain in the affected area.
(2) Itchy skin and eczema: about 1/5 of diabetic patients have itchy skin. Persistent abnormal blood glucose in diabetic patients can stimulate nerve endings and cause itching, which is mainly manifested as generalized or local skin itching, which is common in the hands, elbows, vulva and perianal area. Itchy skin may also disappear after treatment to control blood sugar levels.
(3) Diabetic blistering disease: Diabetic bullous disease is a skin complication that occurs on the hands and feet of patients. This type of blister occurs suddenly, repeatedly, without any conscious symptoms. The blisters vary in size, the walls are thin, the blisters are clear fluid, and there is no redness on the outside of the blisters. It usually heals on its own after a few weeks, leaving pigmentation on the skin when it subsides.
(4) Diabetic xanthelasma: On the skin of the patient's knees, elbows, back or buttocks, groups of yellow papules or small pimples the size of rice grains to soybean grains suddenly appear. This xanthelasma has a shiny surface, generally has no self-conscious symptoms such as itching, and is slightly harder to the touch than the surrounding skin.
(5) Pretibial pigmented spots: characteristic skin lesions of diabetes mellitus, which are more common in elderly patients with a long course of disease. Erythema and papules often appear in front of the tibia on both sides, varying in size and number, clustered or scattered. The development is slow, followed by the appearance of scaly skin surfaces, and finally local skin atrophy or hyperpigmentation, and the patient is asymptomatic.
(6) Diabetic gangrene: common in the lower limbs, especially the toes. Initial local tingling sensation on the skin, followed by gradual or sudden gangrene. Gangrene can occur suddenly, the pain is severe, and in most patients gangrene occurs slowly, with severe nerve damage, the pain can be mild or severe, with minor local injuries and localized small blisters. Later, the subcutaneous tissue becomes dark red or black, and severe limbs, hands and feet ulcerate and necrosis, dry up and blacken, purulent infection, etc.
As a long-term diabetic patient, how to improve the skin problems caused by diabetes?
(1) Holistic care
(1) Control blood sugar levels: Controlling blood sugar levels is essential to improve skin problems caused by diabetes. High blood sugar can affect the skin's moisture retention and repair function, making the skin dry and itchy. Through blood glucose records, you can understand your blood sugar level and control your blood sugar reasonably according to your doctor's advice.
(2) Keep your skin clean: Keeping your skin clean is an important step in preventing infections and improving skin problems caused by diabetes. The water temperature should not be too high, the towel should be soft, and a mild neutral soap should be used to reduce irritation to the skin. Take a warm bath 2~3 times a week, and the bath time is 10~15 minutes each time. Apply an alcohol-free body lotion to the skin after bathing to keep the skin dry in folds, armpits, breast folds, etc.
(3) Check the skin daily: focus on the vulnerable parts, such as limbs, hands and toes, etc., to observe whether there is damage, whether the color is normal, and whether there is abnormal sensation such as local numbness, pain, chill or fever.
(4) Comfortable and clean clothing: wear loose cotton clothes, do not wear chemical fiber underwear, so as not to irritate the skin and cause itching. Disinfect towels regularly and keep bed linen dry and clean.
(5) Balanced and reasonable diet: A reasonable diet is very important for the skin health of diabetic patients. By controlling carbohydrate intake, increasing vegetable and fruit intake, and choosing low-fat, high-fiber protein, it can help improve skin problems caused by diabetes.
(6) Skin abnormalities should be detected and treated as soon as possible. If the skin is broken, the wound can be washed with water and covered with a dry, sterile bandage, or if redness, warmth, oozing or pain occurs, seek medical attention immediately.
(2) Foot care
(1) Diabetic patients should check their feet regularly, pay attention to whether there are any abnormalities such as redness, swelling, ulceration, blisters, etc., and seek medical attention in time if abnormalities are found, and avoid self-treatment. Diabetic patients with poor blood circulation in the lower limbs, prone to numbness and cold feeling, should pay special attention to keeping the feet warm, change shoes and socks frequently, keep them dry, and avoid long-term exposure to cold environments.
(2) Wash your feet in the right way, the water temperature should be below 37°C, and keep the toes dry. Avoid using electric blankets, warm water bags, soak your feet in water that is too close to the heater or too hot, and walk on hot sand or concrete to prevent burns.
(3) Carefully trim the toenails, when cutting the toenails, you should pay attention to ensure that you can see clearly, trim straight, avoid cutting too deep on the edges, cut off the sharp parts, do not let the toenails grow too long, and do not go to the public bathroom pedicure.
(4) Choose shoes with good air permeability, loose and comfortable, try on shoes best in the afternoon, check whether there are foreign objects in the shoes and whether the socks are damaged or threaded before wearing shoes to avoid foot damage. Choose socks made of natural materials, such as cotton thread, wool, etc., socks should not be too small, nor too big, the top of the socks should not be too tight, otherwise it will affect the blood circulation of the feet, and the internal seams of the socks should not be too rough.
To sum up, improving skin problems caused by diabetes requires a comprehensive consideration of internal and external factors. By controlling blood sugar, keeping the skin clean, moisturizing, and preventing infections, I hope that the above experience and suggestions will help you improve the skin problems caused by diabetes. I wish you all healthy and beautiful skin.
(The picture comes from the Internet)