Taking care of our skin is always important, but in diabetes skin care requires more consideration. The skin, our body’s largest organ, is a vital physical barrier between the outside world and everything inside us. Although it seems like a pretty simple thing, there are many blood vessels, nerves and various other structures within it. These all affect the integrity of our skin, and influences how well it does its job.
It’s in Your Blood
One primary cause of medical complications in diabetes is high blood glucose levels, especially if levels are consistently high over a prolonged period of time. High levels of circulating glucose can lead to damage to the body’s blood vessels. Since all organs in the body rely on blood perfusion from these vessels, any damage to them can lead to problems for the respective organs.
People with diabetes may thus be at risk of various complications if their blood glucose levels are not adequately controlled. These may include eye problems (such as retinopathy), kidney damage (nephropathy) and, of course, skin issues. The cells of our skin need good blood flow to maintain its integrity.
Other factors, like high blood pressure and high cholesterol, may also increase the risk of blood vessel damage. For people with diabetes, it’s important for blood pressure and cholesterol to also be monitored regularly. If you have concerns about these, you should talk to your doctor about appropriate monitoring and management.
Nerves Know the Problems
Nerves in the skin detect things like heat and pain to let us know when there are problems or danger present. Over time, high blood glucose can cause damage to the body’s nervous system, affecting the body’s ability to detect when something’s amiss.
For example, in many patients with diabetes, the nerves in the feet can become damaged over time. This means that you could get a wound on your foot, and not notice. Treatment is then unnecessarily delayed until you realise that the wound is there. Consequently, this may increase the risk of further complications such as ulceration and infection.
What Can Go Wrong?
Other possible diabetes skin complications include dry skin, itchy skin and rashes. These may be due to poor blood circulation, leaving the skin dehydrated or lacking in the nutrients that it needs.
If the barrier property of the skin is compromised, this could also lead to infections of the skin and underlying tissues. A common manifestation of this is diabetic foot ulcers. Since our blood also carries immune system cells (such as macrophages and neutrophils), wounds may also be more susceptible to infection if blood flow to the area is compromised.
Furthermore, once a wound is established, it may take longer to heal in someone with diabetes compared to someone without diabetes. This is because our blood also carries cells important to tissue repair and healing.
Drug-induced Diabetes Skin Reactions
Unfortunately, some drugs that are used to treat diabetes can also cause skin problems. Usually these side effects are not common, but it’s good to be aware of this possibility. For example, all sulfonylureas may potentially cause skin rashes. Symptoms may include redness and itchiness, and, if severe, the sulfonylurea will need to be stopped.
Insulin, which is injected just under the skin, may also cause issues. These may be minor, and go away with a bit of time, or these may build up over time. Mild redness and itching may be experienced around the site of injection, but this tends to resolve on its own. If you don’t rotate your injection site, and insulin is frequently injected into the same point, lipodystrophy may occur. Insulin has various effects on lipid/fat metabolism, and frequent injection of insulin into one spot can lead to a build up of fatty tissue in that area (lipodystrophy).
Taking Care of Your Skin
Generally, the most important treatment aims for people with diabetes will be controlling blood glucose, blood pressure and cholesterol. Managing these appropriately will help minimise the risk of complications associated with diabetes. Make sure you talk to your healthcare team about lifestyle and medical interventions that are suitable for you. And remember: prevention is better than cure!
Early detection is also helpful, so diabetes skin care should include some self-monitoring. Talk to a healthcare professional about what symptoms to look out for. They will likely advise you to pay special attention to the skin on your legs and feet, especially the soles of your feet.
Other Measures You Can Take
Dry and Itchy Skin
There’s a vast array of treatments for dry and itchy skin available in shops and pharmacies. Your choice of product will depend on the area you’re treating, the degree of dryness/itchiness you’re experiencing, and various other factors. Your pharmacist or other pharmacy staff should be able to help you choose a product suitable for your condition.
Some lotions, although initially soothing and cooling, may dry out the skin as they dry off, so you should usually avoid these. Alternatively, gels may provide a cooling effect without drying out your skin. Creams that absorb into the skin can be useful for everyday moisturising. These may be available with additional ingredients to help hydrate the skin (such as urea) or soothe itchiness (such as colloidal oatmeal).
Ointments and thick creams are best for holding moisture in the skin, but the greasy feeling can limit their use. Of course, it’s possible to use a combination of products. Perhaps you could use an ointment in the evenings, while you’re at home, and then a cream during the day.
Infections and Wounds
Generally, you can manage minor wounds with over the counter products available in pharmacies. Your pharmacist or other healthcare professional can advise you of the best way to clean and dress your wound. However, if infection appears likely, or if the wound covers a significant area of skin, referral to a doctor will be necessary. Never attempt to treat an infection on your own. It’s best to have it assessed by a healthcare professional in order to determine the best treatment pathway.
Diabetes skin infections – such as foot ulcers – will need antibiotic treatment. Superficial infections may be able to be treated with topical preparations (applied onto the skin), but oral antibiotics (in the form of tablets or capsules) may also need to be prescribed.
Unusual Symptoms
If in doubt, always consult a qualified healthcare professional to determine what sort of care you require. Generally, if a wound is exudating (secreting pus or liquid) and/or has an unusual odour or colour, it is best to seek immediate medical attention. Similarly, if the skin is hot to the touch (for no obvious reason), or if you have a fever or other concurrent illness, you’ll need to consult your doctor.
Eat Your Way to Good Skin Health
A diet that includes a wide range of fruit and vegetables is a great way to improve your skin health. Click on these links to have a read about common fruit myths, and tips on how to include more fruit in your diet. You can also check out the Recipes page to find delicious and easy ways to eat more fruit and vegetables.
Diabetes Skin Health: The Big Picture
In the end, remember that anything that helps manage your diabetes will have flow-on effects for your skin health. Check out these Pro Tips for managing diabetes, and you’ll be well on your way to improving your overall health!
【糖友可能遇上嘅小便問題】
當糖尿病病情失控，就有可能破壞身體唔同部位嘅神經，包括膀胱神經，引致神經性膀胱功能異常。患者可能會有尿頻、尿滲、無尿意、膀胱感染等等。若出現呢啲問題，應盡快向醫生反應，千祈唔好因為怕尷尬導致延誤診治。
要避免糖尿病破壞神經，最理想嘅方法都係保持健康嘅生活方式，例如定期監測血糖、血壓同血脂，戒煙同進行適量運動等等。
一家七口都罹患糖尿病 營養學家教他這樣吃竟然痊癒
記者郭奕均／台北報導
大家常說「病從口入」，很多疾病都是吃出來的，包括三高、心血管疾病和很多的癌症，因此三立新聞網直播節目《奕起聊健康》邀請到國際級的頂尖營養學專家徐嘉博士，深入探討「正確飲食」的重要性，以及如何透過培養正確的飲食觀念，找回健康，也提升身體的自癒能力，甚至讓身體原本的毛病，用最天然的方式自我痊癒、恢復健康！
▲國際權威營養學專家徐嘉博士，在節目中提倡健康蔬食的重要性。
徐嘉博士在節目中強調，生病並不是因為「沒吃藥」造成的，而是因為吃了很多不該吃的東西導致，這些錯誤飲食等於是自我傷害，因此停止這些傷害，恢復身體的自癒能力，的確可能讓身體諸多疾病康復。
徐嘉博士更表示，原本有一家7口全都得糖尿病，他們原本都以為是家族遺傳，「但我告訴他們，不是疾病遺傳，遺傳的是你們的生活方式，都吃同樣的食物，所以導致得了糖尿病」，因此徐嘉博士教他們家族其中一位20多歲年輕人，循著正確飲食，「大約30、40天，他就丟掉藥物和針，身體恢復正常，後來他也教他的父母，他們的身體也慢慢恢復。」
「疾病真的有可能被逆轉 」，徐嘉博士強調，靠的就是「健康疏食」，100%做到低脂純素，就能感受到身體的變化，「但我要強調，素食不能治療任何的疾病，素食唯一能夠做到的，就是停止自我傷害，只要停只自我傷害，身體就能開始自我療癒。」
▲徐嘉博士認為健康蔬食，不吃傷害身體的食物，就能讓身體恢復自癒能力，逆轉疾病。
至於健康蔬食到底該怎麼吃呢？徐嘉博士建議：穀類、豆類、蔬菜、水果各占1/4，而穀類儘量要選擇全穀類，健康的餐盤，是沒有動物性食物的。
而在蔬果豆穀的基礎上，要做到低脂，所謂低脂，就是儘量不吃油，「身體不需要油，不管是動物來源還是植物來源的油，對健康都是減分的，我們儘量吃生的、蒸的、煮的、用水炒的，避免煎、炸，就可以儘量不用食用油。」
再來要避免精緻米飯與麵粉，穀類營養主要在穀皮上，吃去掉了穀皮的精米、精麵，基本就是在吃熱量了，就可能造成營養不平衡，因此徐嘉博士認為，應該吃更有營養的東西，例如糙米、山藥、紅薯、馬鈴薯、玉米…等。
絕大多數吃素無法持久的人，最主要原因是它的熱量攝入不夠。蔬食屬於高纖低脂的飲食，肉食屬於高脂低纖的飲食。我們在吃肉的時候，可能只吃一碗飯就夠了。但是現在改吃素了，一碗飯就不夠了。所以你會發現，吃素之後你的食量會增加，這是正常的。
徐嘉博士也提醒，有些人以前吃肉是吃一碗飯，吃素之後還吃一碗飯，導致吃素之後面黃肌瘦、沒有力氣、低血壓、低血糖…這就是因為熱量吃得不夠，所以「吃夠熱量」是很重要的，除此之外，也要記得補充維生素B12、維生素D、Omega-3脂肪酸，才能真正吃得健康。
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