Can diabetes cause itchy hands and feet?

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The incidence and prevalence of diabetes, also known as diabetes mellitus (DM) is increasing worldwide, especially in industrialized countries in recent years. Approximately 30-70% of patients with diabetes develop cutaneous manifestations during the chronic course of the disease.

1. Skin manifestations related to diabetes

Disturbed insulin hormone and elevated blood sugar levels in diabetics lead to metabolic, vascular, neurological, and immune abnormalities. The organs that can be damaged by diabetes are the heart, kidneys, nervous system, eyes, and skin. Many patients only get a definitive diagnosis of diabetes when the aforementioned internal organs are damaged. Recognizing the possible risk factors for abnormalities in carbohydrate metabolism will help diagnose diabetes early and prevent complications. Skin manifestations can help detect diabetes while diabetes can also aggravate skin conditions. During the chronic course of the disease, about 30-70% of patients with diabetes have skin manifestations.
The following are some of the skin manifestations associated with diabetes:
Diabetic foot (DIABETIC FOOD) A condition in which the feet have ulcers as a result of diabetes combined with neuropathy. Peripheral vasculitis (60-70%), anemia due to peripheral vasculitis leads to anemia (15-20%) or both. Ulcers can occur in pressure points in the feet, even causing infection and gangrene complications.
Diabetic skin disease: (DIABETIC DERMOPATHY) Diabetic skin lesions cause reddish brown skin color. This is small vessel disease, is the most common skin sign of diabetes and is common in more than 50% of patients with diabetes, occurs in men twice as often as women. Lesions often appear: lower legs, sometimes on thighs, arms. Diabetic vascular disease complications can occur in diabetic patients with skin lesions due to specific microvascular disease, such as: retinopathy, neuropathy, nephropathy.

Diabetic Fat Necrosis: (NECROBIOSIS LIPOIDICA) Diabetic fat necrosis occurs in about 1% of diabetic patients, >70% of patients are female. The etiology of the disease is unknown but may be due to inflammation of the small blood vessels in diabetes. Patients with insulin-dependent diabetes can develop fat necrosis lesions very early, averaging at 22 years of age. Meanwhile, they appear later in patients with non-insulin-dependent diabetes or in those with non-insulin dependent diabetes. people without diabetes, average age 49.
Diabetic foot skin itching: (ACQUIRED ICHTHYOSIFORM CHANGES OF THE SHIN) This is one of the most common skin manifestations in patients with diabetes, especially This condition occurs in 50% of young patients with insulin-dependent diabetes, of unknown etiology. May be due to microvascular disease, adhesion lesions of the stratum corneum, increased glycosylation, and accelerated skin aging.
Acanthosis nigricans: (ACANTHOSIS NIGRICANS) On the surface of folds such as: neck, armpits, groin, navel, areola, under breasts, elbows, etc., there is a phenomenon of velvety smooth skin, thickening and hyperpigmentation. element. This symptom is very common, especially in people with type A insulin-resistant diabetes, with the addition of obesity, a factor in the metabolic syndrome. The pathogenesis is that hyperinsulinemia can activate insulin growth factor (IGF-1) receptors on keratinocytes leading to epidermal growth. Very rarely there is a malignant form.
Condition of pustules with skin stalks: (SKIN TAGS – ACROCHORDONS) These are benign tumors, with skin stalks. This condition usually occurs around the neck or in the large folds of the elderly, some patients with diabetes develop benign nodules with skin stalks associated with acanthosis nigricans. The researchers suggested that in people with multiple pedunculated pustules, there is an increased risk of diabetes due to impaired carbohydrate metabolism.
Eruptive yellow granuloma (ERUPTIVE XANTHOMAS) Eruptive granulomatous granuloma is redish yellow papules, 1-4 mm in size. Often the lesions occur in waves and can coalesce into a large patch. Experts believe that fulminant granulomatous granulomas may be the first sign of untreated diabetes, with severe hypertriglyceridemia.
Skin changes resembling scleroderma: (SCLERODERMA – LIKE SKIN CHANGES) This is thickened and hard skin on the backs of the fingers (sclerodactylia) and the proximal or intervertebral joints. These symptoms can affect the forearm, arm, and back, are bilaterally symmetrical, and are painless. Skin changes similar to scleroderma but do not cause, touch the skin feels like wax, no skin atrophy, vasodilation, swelling or Raynaud's phenomenon.
This phenomenon occurs in 10 - 50% of patients with diabetes, male ~ female, most often type I diabetes. It is caused by end products of increased glycosylation that thicken collagen.
Diabetic scleroedema: (SCLEREDEMA DIABETIORUM OF BUSCHKE) Diabetic patients have diffuse and symmetrical edematous edema, sometimes erythematous, appearing mainly on the neck, shoulders, back, possibly spreading to the face . The edematous skin is hard like wood, cannot be pinched, reducing pain. These manifestations are quite rare, usually occur in male patients over the age of 40, with type II diabetes, very rarely in female patients. Most patients develop complications, begin to become insulin dependent, and treatment is often unsuccessful.
Diabetic water blisters: (BULLOSIS DIABETICORUM) Are tight blisters, d~0.5-3cm in size, without surrounding inflammatory halo, usually appearing on fingers, hands, forearms, toes, feet, legs, rarely trunk. Rarely, this type of lesion, which develops acutely and is usually painless and pruritic, occurs in patients with severe diabetes. One of the first signs of diabetes is the appearance of blisters on the ends of the lower extremities.

KYRLE disease (acquired perforated skin): (ACQUIRED PERFORATING DERMATOSES - APD) APD lesions are chronic inflammatory granulomas around the hair follicles, oyster shell-like in shape, central concave keratosis, very itchy, and clustered in streaks. long (Koebner phenomenon), red or pink in white patients, hyperpigmented in black patients, with locations such as trunk, extremities, scalp and face. The source of APD lesions is unknown, possibly due to a secondary inflammatory skin reaction with uremia, uric acid deposition, or scratching trauma. APD is closely associated with 5-10% of patients with diabetes and CKD, usually occurring 10-30 years after diagnosis of diabetes and many months after dialysis.
Erythema: (RUBEOSIS) This condition occurs in about 3%-59% of patients with diabetes whose face, neck and extremities are always flushed, possibly due to decreased vasoconstriction.
Yellow-orange skin: (CAROTENODERMA) In areas of skin with active sebaceous glands (face) and areas with thick horny layer (hands, feet), orange-yellow skin often occurs. This condition can occur in both fingernails and toenails.
Keratosis pilaris: (KERATOSIS PILARIS) This is a very common benign skin disease, manifested by thickened papules around the hair follicles, mainly on the trunk. In the course of diabetes, signs of keratosis pilaris, like acquired ichthyosis, appear early.
Yellow tumor outbreak: (ERUPTIVE XANTHOMAS) The sign of yellow tumor outbreak is many yellow or red-brown rashes that suddenly break out all over the body, mainly on the backs of the hands, feet, legs and trunk. . Common in young, male patients with type I diabetes. Lesions are papules with a dermis impregnated with triglyceride-filled macrophages, as opposed to cholesterol ester-containing cysts. This is the case in diabetic patients with elevated blood triglycerides.
Skin infections: (Fungal, bacterial infections) Skin infections can occur in 20-50% of diabetic patients, most of them in type II diabetes are not well controlled blood sugar leading to abnormality microcirculation, decreased phagocytosis, impaired leukocyte adhesion, and slowed chemotaxis.
Fungal infections: Among diabetic skin infections, fungi account for the highest rate because the patient has a weakened skin barrier, the most common is Candida infection and this is often a warning sign. first of diabetes. Interstitial inflammation, stomatitis, nail inflammation, balanitis, vulvovaginitis can also be caused by Candida yeast infection.
Other fungal infections of the skin of diabetes are usually: interstitial fungus, erysipelas, cellulitis, more seriously, fungal sepsis. Diabetic patients with ketoacidosis are very susceptible to infection with the fungus Phycomycetes (mucormycosis) causing central vascular necrotic lesions, especially in the oropharynx, which can cause encephalitis, and most patients die. death.
Bacterial infections: Compared with other diseases, skin infections of diabetic patients are 3 times higher, mostly caused by Gram-negative bacteria such as Pseudomonas aeruginosa, especially in diabetic foot ulcers, which is a symptom that should not be taken lightly because patients may experience amputation, severe sepsis, and drug-resistant P. aeruginosa. Diabetics are also very susceptible to pyoderma, erysipelas, cellulitis caused by group A & B Streptococcus infections, and methicillin-resistant Staphylococcus aureus (MRSA) if not well controlled.

2. Skin complications due to diabetes treatment

The use of antidiabetic drugs can cause some skin reactions, such as: urticaria, erythema multiforme, rosacea, lichenoid rash. Photosensitive skin may occur with the use of Tolbutamide and chlorpropamide. Sulfonylureas are the class of hypoglycemic agents that most commonly cause allergic skin reactions. Compared with the 1st generation, the 2nd generation sulfonylureas drugs cause less side effects.
Lipoatrophy at the insulin injection site, usually in the abdomen and thighs, occurs 6-24 months after the injection is started. This condition is more common in children and women Lipohypertrophy: This condition is common in 20-30% of patients with type I diabetes and 4% with type II diabetes at the site of frequent insulin injections. with a high dose a day, using the needle many times and the injection site unchanged. These are tender skin nodules that resemble lipomas. Injecting insulin into sites of adipose tissue proliferation can slow insulin absorption, leading to erroneous glycemic control and unpredictable episodes of hypoglycaemia. Rarely, an allergic reaction to insulin may occur. Human insulin is less likely to cause allergic reactions and disorders of adipose tissue, produced by recombinant DNA technology.
Allergic skin reactions to insulin may be urticaria or delayed hypersensitivity (serum disease).

3. Some causes of itchy hands and feet

When your hands and feet are itchy, proper treatment can help relieve some of the symptoms. However, how you treat itchiness depends a lot on what's causing the problem, including:
Dry skin: It could be due to winter weather or too much scrubbing. Itchy hands and feet can also be a sign of another health condition, such as psoriasis. inflammation. Itchy hands and feet due to scabies: A species of eight-legged beetle, known as the human itch bug, is the source of this common skin condition. This small insect moves deep into the top layer of the skin and lays eggs there, causing scabies.

Diabetes is also a cause of itchy hands and feet : Certain skin problems are sometimes the first sign that you have diabetes. For example, Xanthomatosis, another condition caused by uncontrolled diabetes, makes the hands and feet feel itchy. This symptom will disappear when the disease is well controlled. Xanthomatosis can also cause itching in your arms, legs, and buttocks. Xanthomatosis also causes a number of other problems, such as: small pimples on the skin, high cholesterol levels... Itchy hands and feet due to allergies: The skin can react allergic to things that you have touched. The reaction you see and feel is also known as allergic contact dermatitis.

4. Limiting the effects of diabetes itch

The treatment of itching is most effective only when the exact cause of the condition is identified.
In addition, to limit the effects of itching, patients need to follow a reasonable diet and lifestyle:
Consume foods rich in fiber, low in cholesterol and low in saturated fat. Limit the use of refined grains instead, use whole grains and add some form of protein to each meal.

Always keep your mind at ease: Do not let worries and stress about illness affect your life. Worrying not only does not alleviate the condition, but it can even make it worse. Exercise regularly: You can control your blood sugar levels through physical activity. Besides, regular exercise helps your body use insulin better.

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Reference source: webmd.com