Diabetes and Skin Infections
Bacterial skin infections are pretty common with diabetes, says Betul Hatipoglu, MD, an endocrinologist in the Endocrinology and Metabolic Institute at Cleveland Clinic in Ohio. "It can be as simple as a boil in the armpit or on the face, infection of the hair follicles, or infection of the nail bed," she says. According to Hatipoglu, almost a third of people with diabetes will get a skin infection at some time in their life.
Fungal infections are pretty common too, according to Hatipoglu. People with diabetes are likely to develop fungal infections in areas that get hot and sweaty, including:
- Under the breasts
- Between fingers and toes
- In the armpits
- In the groin area
- Around the tip of the penis in uncircumcised men
Athlete's foot, jock itch, and vaginal infections are all very common in healthy people as well as people with diabetes. But they can be more difficult to treat if you have diabetes.
So what's the best way to fight infection? "You have to make sure your blood sugars are within a normal range as much as possible," Hatipoglu tells WebMD. "Bacteria and fungi like sugar, and they will multiply like crazy if you don't."
Hatipoglu suggests these tips for preventing and controlling skin infections:
- Check your feet and any areas of your body that get damp and sweaty every day.
- Use moisturizer on dry skin daily to prevent it from cracking and itching. Don't apply moisturizer between your toes.
- If you think you have an infection anywhere on your body, call your doctor.
- Don't try to treat skin infections at home with over-the-counter products because they may not be strong enough.
Diabetes and Injection-Related Skin Problems
If you inject insulin, you can develop skin problems at the injection site. Hudson says that two of the problems, hypertrophy and atrophy, were more common in the past, but they still happen.
- Hypertrophy. If you keep injecting insulin in the same exact spot, a little mound of fat tissue can build up. Hypertrophy can be unsightly and cause insulin to be absorbed less effectively .
- Atrophy. With this less-common condition, Hudson says, "You actually lose the fatty tissue underneath an area of injection. So it's like a dimple." This can cause erratic insulin absorption, making it difficult to control blood glucose levels.
Some people who use insulin pumps have an allergic reaction to the adhesive used to secure it to the skin. Other people may be allergic to some types of insulin. Allergic reactions can range from swelling and itching to life-threatening symptoms. Your doctor can advise you on other options for either of these issues.
Preventing Injection-Related Diabetes Skin Problems
They key to preventing some skin problems from injecting insulin is to rotate injection sites, according to Hudson and Hatipoglu. If you inject insulin with a syringe or pen, pick a new injection site an inch or so away from the last one each time. If you use an insulin pump, rotate sites every two to three days. To prevent infection, wash your hands and the site before injecting.
Kindelan, who has been injecting insulin for most of her adult life, says she has worked hard to avoid skin problems and it has paid off. "I've never had them," she says. Though she has a bit of scarring, Kindelan says, "You just don't use those sites if that happens. I take four injections a day, so I rotate sites."
Hatipoglu and Hudson also recommend injecting insulin in different areas of the body to avoid skin problems. Depending on the area – such as the abdomen, hips, thighs, arms, or buttocks -- insulin will be absorbed faster or slower.
"In the summer, I tend not to use my legs," Kindelan says. "I think everybody feels kind of weird about using their stomach, and I avoided it for awhile. Then it just seemed like too much prime territory, and it wasn't going to show. It's decidedly the most painless of all areas."