A CLINICOEPIDEMIOLOGICAL STUDY OF DERMATOLOGICAL MANIFESTATIONS IN DIABETES MELLITUS: A COMPREHENSIVE STUDY AT A TERTIARY CARE CENTER
Creators: name: Samyuktha Sendhil
name: Dr. Thillaikaraisi
name: Dr. Afthab Jameela Wahab
name: Poongundran. C
Publisher: name: Zenodo
Year: 2024

description: Abstract

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder characterised by persistent hyperglycemia due to defects in insulin secretion, insulin action, or both. The global prevalence of diabetes is increasing, with an estimated 700 million adults projected to be affected by 2045, posing significant public health challenges. Dermatological manifestations are common complications of diabetes, impairing quality of life and serving as early indicators of systemic issues. Various skin conditions, including diabetic dermopathy, necrobiosis lipoidica, acanthosis nigricans, and diabetic bullae, arise from microvascular, macrovascular, neuropathic, and metabolic changes associated with diabetes. Despite their prevalence, these manifestations are often under-recognized and inadequately addressed in clinical practice. This study investigates the spectrum, prevalence, and clinical correlates of dermatological disorders in diabetic patients in a tertiary care setting, enhancing understanding and improving patient care. Methodology: This clinicoepidemiological study was conducted at the Dermatology Department of Saveetha Medical College. The study included diabetic patients aged 18 and above with dermatological manifestations, excluding those with other systemic diseases or medications affecting the skin. Data collection included clinical assessment by a dermatologist, glycemic control (HbA1c levels), duration of diabetes, presence of complications, and quality of life assessment using the Dermatology Life Quality Index (DLQI). Statistical analysis was performed using SPSS version 26.0, with chi-square tests, t-tests, ANOVA, and multivariate logistic regression to identify independent predictors of dermatological manifestations. Results: A total of 200 diabetic patients with dermatological manifestations were included. The mean age was 55.4 ± 12.3 years. Type 2 diabetes was present in 85% of patients, and the mean duration of diabetes was 10.2 ± 6.8 years. Poor glycemic control (HbA1c > 8%) was associated with a 90% prevalence of skin conditions, compared to 70% in moderate control and 50% in reasonable control (p < 0.001). Patients with diabetes duration > 10 years had an 80% prevalence of dermatological conditions, compared to 60% in those with < 10 years (p = 0.002). The presence of microvascular complications was associated with 85% prevalence of severe dermatological manifestations (p < 0.001), and macrovascular complications with 75% (p = 0.004). DLQI scores indicated a moderate impact on quality of life, with higher scores in patients with poor glycemic control and longer diabetes duration (p < 0.001). Multivariate analysis identified poor glycemic control (OR = 3.5, 95% CI: 1.8-6.8, p < 0.001), longer duration of diabetes (OR = 2.8, 95% CI: 1.5-5.2, p = 0.001), and presence of microvascular complications (OR = 4.2, 95% CI: 2.3-7.9, p < 0.001) as independent predictors of severe dermatological manifestations. Conclusion: This study highlights the significant burden of dermatological manifestations in diabetic patients, particularly those with poor glycemic control, longer disease duration, and diabetes-related complications. Regular dermatological assessments and effective glycemic management are essential to prevent and mitigate skin complications, improving clinical outcomes and quality of life for diabetic patients. Integrating dermatological care into overall diabetes management can ensure a holistic approach, enhancing patient health and well-being.