Skincare for Diabetics in Summer

Diabetes is a fairly common ailment affecting a large number of people. But then common illnesses have several solutions. Dry skin, dark spots and edema are the usual foot problems faced by diabetic patients especially in summers. A regular visit to the podiatrist and  keeping your skin hydrated can solve these common skin problems that can occur due to various reasons. Patients with both Type 1 and type 2 Diabetes might have several queries regarding foot care and Senior Consultant Physician and Diabetologist  Dr Dilip Gude of Virinchi hospitals have answers to those frequently asked questions on foot and skincare in summers

Can diabetic patients under medication develop skin problems when exposed to sunlight for long duration? What kind of diseases or skin issues can crop up?

Variety of skin disorders exist specific to diabetics most of which flare up in summer. Excess heat and sweating may encourage nidus for infections(bacterial and fungal). Diabetic dermopathy, bullous diseases, necrobiosis lipoidica, Acanthosis nigricans may worsen in the summer heat.

 Are skin problems different for type 1 and type 2 diabetic patients because most of them develop permanent black blemishes in their skin?

Acanthosis nigricans is characterized by black blemishes on skin and this condition is seen mainly in type II diabetics secondary to insulin resistance. Vitiligo occurs more commonly in type I diabetics and is known to worsen in summer with sun exposure.

Edema and other foot problems are also common in diabetic patients. How to cure that?

Foot ulcers are an important cause of morbidity in patients with diabetes. Both vascular and neurologic disease increase the risk of foot ulcers. A comprehensive foot care is required for diabetics in summer with special attention to pulses of the feet, checking if sensations intact or not and making sure adequate protective footwear is worn all the time. The threshold for a foot ulcer to develop in a diabetic directly depends on the glycemic control over the past few years

How poor glucose control level can affect diabetic patients and how to prevent that?

Poor glycemic control affects almost every organ in the body and skin and nerves are no exception. Loss of sensation due to neuropathy secondary to poor sugar control precedes the development of chronic non-healing diabetic foot ulcers. The poor blood supply from peripheral vascular disease (again potentiated by poor glycemic control) hampers healing of the ulcers. Loss of skin integrity through ulcers then welcomes dreaded infections. Good glycemic control, cholesterol lowering medicines, and careful and comprehensive foot-care can help prevent such ulcers.

Can heat exhaustion create changes in the skin of diabetic patients and how to cure that?

Heat exhaustion can affect body’s thermostat especially on a background of autonomic neuropathy and diabetics are poorly equipped to adjust body temperature as per surroundings. Moreover warm skin encourages increased injected insulin absorption (may cause low sugars) while cold skin delays (may cause increased sugars). Proper hydration and good glycemic control can help improve such skin status.

Which kind of sunscreen and post sun care will you suggest for diabetic patients?

It is advisable to use a sun screen lotion with a sun protection factor(SPF) of at least 30 (SPF30 or higher) and ensure that during 11am and 3pm time is spent in shade as much possible.  Sulphonylureas (an oral antidiabetic medication such as Amaryl/Zoryl) may worsen photosensitivity

Dryness of skin and excessive perspiration can lead to fungal and other skin infections in diabetic patients in summers, how to cure that?

Apart from ensuring good glycemic control, adequate hydration is recommended as the thirst centers may be under-functional in poorly controlled diabetics. Ensuring that the skin is cool and dry with desiccants like talc powder in inter digital area in feet, well fitting and protective footwear can be some of the preventive measures against infections

Outdoor activities are common in summers so how can diabetic patients tend to cut and scrapes?

It is very important that cuts and scrapes are avoided at all cost in diabetics as healing may not only be delayed but it may invite infections. Immediate antiseptic measures and medical help are mandatory when such bruises occur. Full hands-clothing, avoiding shorts and being vigilant about impending injuries may help prevent complications that otherwise may turn catastrophic.

For Appointments :  Dr Dilip Gude , Senior Consultant Physician and Diabetologist  of Virinchi hospitals.