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INTRODUCTION

KEY POINTS

  • Common dermatoses such as intertrigo, tinea corporis, hair loss, and pruritus can be signs of diabetes.

  • A recognition of the early cutaneous manifestations of diabetes can direct the healthcare provider to test for this condition or to refer the patient to a specialist for diabetes treatment. This may result in decreased morbidity and mortality in diabetic patients.

  • Diabetes rates are higher among obese patients, and in many regions of the world, obesity is occurring with an increased prevalence.

  • Genetics can affect an individual’s likelihood of developing diabetes.

  • Diabetes affects every organ of the body, but the highest morbidity is in the heart and kidneys. If patients are treated early and make the appropriate lifestyle changes, the symptoms of diabetes can usually be well managed.

  • Some common cutaneous conditions induced by diabetes include skin infections, granuloma annulare, diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic bullae, leg and foot ulcers, scleredema, and acanthosis nigricans.

Cutaneous manifestations of diabetes are seen daily in the practice of all medical specialties. An estimated 25.8 million Americans have diabetes, and approximately one-quarter are unaware of their condition.1 A further 79 million individuals have elevated blood sugar levels consistent with prediabetes.1 In the United States, type 2 diabetes is currently most prevalent among Native Americans and African Americans, whereas the lowest prevalence is found among Asian Americans [Table 68-1].2,3,4 However, it is important to note that the patient population seen by healthcare providers is changing, and this is likely to impact diabetes statistics in the United States. The U.S. Census Bureau projects that by the year 2060, the U.S. population will shift from 63% to 43% Caucasian, whereas the Latino/Hispanic population will increase to 31%, the African American population to 14.7%, the Asian American population to 8.2%, and the Native American population to 1.5%.5

TABLE 68-1The prevalence of type 2 diabetes in correlation with obesity in Caucasians, Hispanics, African Americans, Native Americans, and Asian Americans2,3,4

EPIDEMIOLOGY

Diabetes is classified by type. Type 1 diabetes is a disease characterized by an autoimmune destruction of the pancreas β-cells, and this leads to a complete lack of insulin secretion. Type 1 diabetes is typically seen at a younger age and is more common in patients with a family history of other autoimmune diseases.

Type 2 diabetes is a disease of impaired insulin secretion and/or ...

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