Impact of Glycaemic Control on the Pattern of Cutaneous Disorders in Diabetes Mellitus- A Hospital Based Case Control Study WC01-WC05
Dr. Pullabatla Venkata Siva Prasad,
Plot Number-350, Second West Cross Muthiah Nagar Annamalai Nagar Post, Chidambaram-608002, Tamil Nadu, India.
Introduction: The skin is the largest and the most visible organ of the body. It is a well known fact that it is referred to as window or mirror to the internal health of the body. Abnormalities of insulin and elevated blood glucose levels lead to metabolic, vascular, neurological and immunological abnormalities. Affected organs include the cardiovascular, renal, nervous system, eyes and the skin. The skin manifestations can be the first presenting sign of diabetes but more often appear in known diabetic patients during the course of the disease.
Aim: To study the clinical profile of cutaneous lesions in diabetic patients and to compare the pattern of these dermatoses with HbA1C levels (glycosylated haemoglobin).
Materials and Methods: Three hundred consecutive diabetic patients with cutaneous manifestations who attended dermatology OPD at Rajah Muthiah Medical College, Chidambaram from November 2013 to October 2015, constituted the study group. Hundred age and sex matched non diabetic patients who attended our OPD, constituted the control group. They were subjected to relevant investigations. Fasting blood sugar, post prandial blood sugar, glycosylated haemoglobin levels and renal function test were done for all patients. Potassium hydroxide mount and gram stain were done for relevant cases. Chi-square test was used for statistical analysis using software SPSS version 21.
Results: The most common dermatological manifestation among diabetics was cutaneous infections, seen in 126 (42%) patients. Among the infections, fungal infections predominated in 89 (29.7%) patients, followed by bacterial infections in 31(10.3%) patients. There was a statistically significant correlation between infections and uncontrolled diabetes (HbA1C >7).
Conclusion: Skin is involved quite often in diabetics, some of which can be a consequence or can be a clue for the diagnosis of underlying diabetes. Diabetic control is very important in reducing the morbidity and mortality of the diabetic patients.