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What Does Diabetic Itching Feel Like?

Diabetes is a complex condition where persistently high blood glucose can have a negative impact on your general well-being by increasing your risk of developing diabetes complications, which can vary from cardiovascular disease, increase in stroke risk [1], deterioration in kidney function [2] as well as skin disease. [3]

People living with diabetes can present with a variety of skin diseases ranging from blistering, infection, redness, and itchiness. This article will focus on itchy skin in people living with diabetes.

Diabetes and Skin Conditions

People living with diabetes are more prone to certain skin conditions and infections in comparison with people who do not have diabetes. This is especially true if your blood glucose is poorly controlled or in patients with newly diagnosed diabetes.

Examples of skin conditions are [4]:

Acanthosis nigricans

  • Dark velvety skin on the neck, armpit or groin is a sign of insulin resistance, commonly in people with type 2 diabetes and obesity.

Fungal infection

  • Commonly seen with yellowish discolouration of the toenails, athlete’s foot and jock itch, which can lead to itching.
  • Occasionally, it can develop small blisters and cause the surrounding skin to be red, hot and swollen.

Cellulitis

  • It can occur when there is skin breakage causing bacterial infection.
  • Surrounding skin can be red, hot, and swollen.
  • Diabetes dermopathy

Diabetes dermopathy

  • Red or brown patches that mainly occur on your shins.
  • It is not painful or itchy, and it is harmless.

Necrobiosis lipoidica

  • Usually, it starts as a small papule that looks like pimples before turning into patches of swollen, hard skin.
  • This condition is rare but can be itchy and painful when it occurs.
  • Women are more likely to have it than men, and treatment is mainly focused on managing signs and symptoms.

Blisters

  • This can occur if blood glucose levels are predominantly high over time.
  • Most blisters will resolve on their own.

Eruptive xanthomatosis

  • These small reddish-yellow bumps can be tender and itchy.
  • Commonly found at the back of your hands, feet, arms, legs and buttocks.
  • It is usually caused by high levels of cholesterol and triglycerides in the blood.
  • It may require cholesterol levels to be checked and may require treatment to lower cholesterol levels.

Digital sclerosis

  • Tight, thick, waxy skin can lead to finger joints becoming stiff and hard to move.
  • It is more commonly seen in people with poorly controlled type 1 diabetes.

Dry, itchy skin

  • In people with diabetes, this can be a result of poor blood circulation or peripheral neuropathy. 
  • It is important to keep your blood glucose within the target range as well as to apply appropriate emollients and topical products to keep your skin hydrated.

Why do people with diabetes develop itchy skin?

There are many causes that can lead to itchy skin, such as:

Infection [4]

  • Either fungal or bacterial infection can cause itching
  • Usually, the surrounding skin will be inflamed, red and swollen

Poor circulation or neuropathy [5]

  • People with diabetes neuropathy or poor circulation can lead to chronic itching.
  • People with kidney disease can have itchy skin due to the build-up of toxins (Uraemia) [6]

Poor diabetes control

  • People with persistently high blood sugar are at increased risk of developing infection and diabetes-related skin conditions.
  • Some of the skin conditions can improve with improved glycemic control.

How to reduce itchy skin?

As itchy skin is an unpleasant sensation, it is important that we take steps to relieve it. As there are many causes of itchy skin, it is vital that we treat the underlying cause and improve glycaemic control to relieve itchy skin.

If there are signs of infections, this is best treated with antibiotics or antifungals,
In people with poor blood circulation, exercise can improve blood circulation in the long run.
In people with dry skin, consider using cream or ointment rather than lotion for moisturiser. It is also important to bath and shower using warm water as hot water can remove moisture from your skin, leaving it to be dry and uncomfortable. [7]

FAQ

Can Too Much Sugar Make Me Itch?

Too much sugar in the body can lead to diabetes, and poorly controlled diabetes increases the risk of skin infection, dry skin and neuropathy, which leads to itchy skin. Also, poorly controlled diabetes increases the risk of developing kidney disease, which, over time, can result in itchy skin due to the build-up of toxins. Hence, it is important to keep one’s blood glucose within target levels to reduce the frequency and intensity of itchy skin.

How to Relief Skin Conditions with Prediabetes?

If you are worried about developing skin conditions and were told to have prediabetes, it is important to start changing your lifestyle and diet to keep your blood sugar within the non-diabetic zone. By doing that, you can reduce your risk of developing type 2 diabetes.

As type 2 diabetes occurs due to obesity and insulin resistance, losing 5% of your body weight can significantly reduce your risk of developing type 2 diabetes. Eat a healthy and balanced diet as well, and being more active in your daily life will help in reducing the risk of developing type 2 diabetes. [8]

In terms of relieving skin conditions, it is important to treat the underlying cause of the skin condition. If the skin condition occurs due to infection, then treatment will usually consist of antibiotics or antifungals, and if it is due to dry skin, then appropriate moisturiser and using warm water for baths and showers should improve the skin condition.

Do Itchy Positions Matter (Feet, Legs, Arms, Ankles, Scalp, Back)?

Some of the skin conditions are more prone to develop in certain areas than others, which will be useful in diagnosis.

When to see a doctor?

As most itchy skin will resolve on its own, it is important to speak to your doctor about it, as they might need to intensify your medications to bring your blood glucose into the target range. Also, some of the skin conditions will need to be treated with medications such as steroids, antifungals or antibiotics, which will need a doctor’s prescription for it.

Final Thoughts

Although itchy skin is common and can occur in people without diabetes, it is very distressing for some people as it can lead to disruptive sleep and cause disturbance in activities of daily life.

It is important to treat the underlying cause of the skin condition and ensure that blood glucose is within the target range to prevent recurrence and further complications such as diabetes, kidney disease and neuropathy, which can lead to chronic itchy skin.

References:

  1. Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015 Oct 10;6(13):1246-58. doi: 10.4239/wjd.v6.i13.1246. PMID: 26468341; PMCID: PMC4600176.
  2. Bonner R, Albajrami O, Hudspeth J, Upadhyay A. Diabetic Kidney Disease. Prim Care. 2020 Dec;47(4):645-659. doi: 10.1016/j.pop.2020.08.004. Epub 2020 Sep 23. PMID: 33121634.
  3. Diabetes: 12 warning signs that appear on your skin (no date) American Academy of Dermatology. Available at: https://www.aad.org/public/diseases/a-z/diabetes-warning-signs (Accessed: 26 September 2023).
  4. Diabetes and your skin (2022) Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/diabetes/library/features/diabetes-and-your-skin.html (Accessed: 26 September 2023).
  5. Pérez Buenfil LA, Fortier J, Almeda-Valdes P, Güereca Olguín DC, Mena-Hernández L, Corona-Hernández MLÁ, Lima-Galindo AA, Barbosa B, Sánchez-Gomez JE, Hernández A, Domínguez-Cherit J, Valdés-Rodríguez R. Multifactorial causes of chronic itch in diabetes: More than just neuropathy. Australas J Dermatol. 2023 Aug;64(3):354-358. doi: 10.1111/ajd.14092. Epub 2023 Jun 1. PMID: 37264566.
  6. Stefaniak, A. A., Krajewski, P. K., Bednarska-Chabowska, D., Bolanowski, M., Mazur, G., & Szepietowski, J. C. (2021). Itch in Adult Population with Type 2 Diabetes Mellitus: Clinical Profile, Pathogenesis and Disease-Related Burden in a Cross-Sectional Study. Biology, 10(12). https://doi.org/10.3390/biology10121332
  7. Dermatologist-recommended skin care for people with diabetes (no date) American Academy of Dermatology. Available at: https://www.aad.org/public/diseases/a-z/diabetes-skin-care (Accessed: 26 September 2023).
  8. Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and Management of Type 2 Diabetes: Dietary Components and Nutritional Strategies. Lancet (London, England), 383(9933), 1999. https://doi.org/10.1016/S0140-6736(14)60613-9

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