If the skin is red, dry or itchy, very few people suspect a serious metabolic disease. But that is exactly what can be the cause of such complaints. Around 80 percent of all diabetics have skin problems. Because an increased blood sugar level damages the cells and thus also affects the skin structure.

“The so-called ‘saccharification’ of proteins, fats and nucleic acids plays a central role in skin diseases in diabetes,” report the German Diabetes Center in Düsseldorf and the German Center for Diabetes Research on a common platform . “Advanced saccharification of these molecules can alter the structure and function of the skin.”

Seven skin characteristics can occur in diabetes

People with type 2 diabetes are more likely to have it as people with type 1. A total of around 4.6 million people in Germany have diabetes, most of whom have type 2 diabetes.

Certain skin changes can be the first sign of diabetes, even before the disease is detected. These include:

1. constant itching
2. extremely dry skin
3. Redness of the skin
4. severe callus formation on the feet
5. Wounds and poor wound healing
6. Hardening of the palms
7. no sweat formation even at high temperatures or physical exertion

Why does the skin react with diabetes?

Studies show that people with diabetes are more likely to suffer from various skin diseases. However, it is not always clear how exactly the two diseases are related to each other.

In most cases, the main cause of a skin reaction is an increased blood sugar level. High levels can, among other things, affect the so-called keratinocytes and fibroblasts in the body. Keratinocytes are cells on the surface of the skin that produce keratin, which protects the skin and keeps it elastic. Fibroblasts are part of connective tissue. They also keep the skin elastic and resilient.

If the work of both cell types is disrupted by a persistently high blood sugar level, bacteria, viruses and fungi penetrate the skin more easily. In addition, wound healing works worse.

One of the common bacterial infections in diabetes is the so-called erysipelas, in which red spots spread quickly on the skin, sometimes accompanied by swollen lymph nodes, fever and chills. Dwarf lichen (Erythrasma) causes scaly patches that turn reddish-brown, usually in skin folds, under the armpits or in the genital area.

Well-known fungal infections in diabetes are tinea, an infection on the foot and in the spaces between the toes caused by a filamentous fungus. And infections caused by the yeast Candida albicans, which can cause itching, weeping and burning areas.

Skin problems caused by diabetes – here’s what you can do

The good news: As soon as diabetes is diagnosed and treated properly, most skin problems should disappear. The blood sugar level should be within the individual target range that patients have defined with their diabetologists.

The German Diabetes Center and the German Center for Diabetes Research also provide the following skin tips:

• Keep the skin clean and do not degrease your skin by washing it too often with soap.
• Provide the skin with plenty of moisture, for example with oil baths, a normal skin lotion or creams and ointments containing urea.
• Avoid baths and showers that are too hot.
• Take good care of your feet and check them every day for sores. Avoid applying lotions, creams, or ointments between the toes unless you have a fungal infection in the area. The extra moisture there can encourage fungal growth.