Frequency of cutaneous involvement in diabetes and its association with glycemic control: A cross-sectional study at tertiary care hospital Karachi
DOI:
https://doi.org/10.55629/pakjpathol.v37i3.1039Abstract
Objective: To determine the incidence of skin involvement in diabetic patients, and its correlation with glycemic control in a tertiary care hospital.
Material and Methods: This cross-sectional descriptive study was conducted at the Dr Ruth K.M Pfau Civil Hospital Karachi, Dow University of Health Sciences from 1st April 2026 till 30th July 2026. The patients who had diabetes mellitus were selected by employing non-probability consecutive sampling technique in which 171 patients were recruited. We included patients with diabetes who had a duration of ≥5 years and were 20-70 years old. Demographic data, characteristics of diabetes and HbA1C were gathered via a structured proforma. Glycemic control was defined as good glycemic control (defined as an HbA1c <7%) based on American Diabetes Association guidelines. SPSS version 22 was used for data analysis. A p-value ≤0.05 was considered statistically significant.
Results: In 171 diabetic patients, 107 (62.6%) had at least one cutaneous manifestation. The most common findings were xerosis (59, 34.5%), followed by dermatophytosis (51, 29.8%), diabetic dermopathy (43, 25.1%), skin tags (38, 22.2%), and acanthosis nigricans (35, 20.5%). Cutaneous involvement was significantly higher among patients with poor glycemic control compared with good glycemic control (72.4% vs. 41.8%, p<0.001) and among patients with diabetes duration >10 years compared with those having diabetes duration of 5–10 years (75.9% vs. 51.1%, p=0.002).
Conclusion: Diabetic patients often have cutaneous manifestation that are more noticeable in those who have poor glycemic control or longer duration of diabetes.
Keywords: Diabetes mellitus, Glycemic control, Hyperglycemia, Skin diseases, Xerosis.
References
Yousaf S, Riaz M, Irfan M, Atif N, Javaid QA, Javed SG. Frequency of cutaneous skin manifestations among patients with diabetes mellitus at a tertiary care hospital: a cross-sectional survey. J Pak Soc Intern Med. 2025; 6(3): 233-8.
DOI: https://doi.org/10.70302/jpsim.v6i3.2543 .
Fahad R, Soban M, Qasim SF, Aziz Z, Mughal F, Azim F. Frequency of skin disorders in type 2 diabetes mellitus: a cross-sectional study. J Liaquat Univ Med Health Sci. 2024; 23(2): 155-9. DOI: https://doi.org/10.22442/jlumhs.2024.01095
Mandal N, Praveen P, Sen S, Banerjee S, Dey P, Mandal S. Cutaneous manifestations of diabetes mellitus: correlation with HbA1c level—a cross-sectional observational study from a tertiary care center in Eastern India. Ann Med Sci Res. 2023; 2(3): 144-50. DOI: https://doi.org/10.4103/amsr.amsr_57_22
Karra MC, Maheswari PM, Atluri SC, Samanthula H. Dermatological manifestations in diabetes mellitus and its relation with HbA1c levels—an observational study. IP Indian J Clin Exp Dermatol. 2024; 10(4): 393-7. DOI: https://doi.org/10.18231/j.ijced.2024.069 .
Durgavathi C, Deepa K, Daniel SJ, Sampath V. A clinicoepidemiological study of pattern of skin disorders among diabetes mellitus in a tertiary care centre. IP Indian J Clin Exp Dermatol. 2024; 10(1): 51-9. DOI: https://doi.org/10.18231/j.ijced.2024.009
Zubair M, Gillani A, Malik MK, Niazi S, Perveen Z, Bano A. Association of cutaneous manifestations with undiagnosed diabetes mellitus in adults. Pak J Health Sci. 2025; 6(6): 33-6. DOI: https://doi.org/10.54393/pjhs.v6i6.3195
Tirmizi SS, Zulfiqar M, Moosa E, Rasool R, Shami S, Alam A, et al. Association of dermatological manifestations in patients with type 2 diabetes mellitus with respect to duration of diabetes. Cureus. 2025; 17(7): e88681.
DOI: https://doi.org/10.7759/cureus.88681
Khan D, Ahmad J, Arif M, Khan K, Bari J, Ali F, et al. Evaluation of cutaneous manifestations in patients with diabetes mellitus: Association with non-alcoholic fatty liver disease and other gastrointestinal complications. Cureus. 2025; 17(11): e95882. DOI: https://doi.org/10.7759/cureus.95882 .
Afroz F, Hasan MR, Yeasna KF. Frequency, spectrum, and predictors of skin, hair, and nail manifestations in patients with type 2 diabetes mellitus. Bangladesh J Endocrinol Metab. 2025; 4(3): 143-8. DOI: https://doi.org/10.4103/bjem.bjem_7_25
Vâță D, Stanciu DE, Temelie-Olinici D, Porumb-Andrese E, Tarcău BM, Grecu VB, et al. Cutaneous manifestations associated with diabetes mellitus—a retrospective study. Diseases. 2023; 11(3): 106. DOI: https://doi.org/10.3390/diseases11030106
Merdin AF, Aydemir AT, Korkmaz FN, Unal Sah FT, Gokcay CA, Oktem A, et al. Evaluation of chronic pruritus and associated skin findings in patients with diabetes mellitus. Turk J Med Sci. 2023; 53(5): 1489-97. DOI: https://doi.org/10.55730/1300-0144.5716
Kalra S, Mittal A, Rathod RM, Pinto C, Rathod R, Mane A. Knowledge, attitude and practice for pruritus management in physicians and patients with diabetes. Clin Pract. 2022; 12(1): 27-36. DOI: https://doi.org/10.3390/clinpract12010004
Kumar D, Mehta RD, Ghiya BC, Soni P, Mohta A, Agrawal RP. An epidemiological study of cutaneous manifestations of diabetes mellitus at tertiary care centre of North West Rajasthan, India. Our Dermatol Online. 2022; 13: e51. Available from: https://www.odermatol.com/oderm atology/2022e/E440.epidemiological-KumarD.pdf
Elbqry MG, Elmansy FM, Qalawa SAA, Alolayan MM, Alshitwy AA, Elgazzar SE, et al. Dermatological manifestations and skin care practices associated with self-efficacy among adults with type 2 diabetes mellitus in Qassim region, Saudi Arabia: a multicenter study. Front Public Health. 2026; 14: 1846781. DOI: https://doi.org/10.3389/fpubh.2026.1846781
Marinescu M, Botnariu GE, Mocanu M, Vâță D, Temelie-Olinici D, Halip I, et al. Skin lesions in diabetes mellitus: A 6-year observational study and 11-year longitudinal analysis of hospital admissions from northeast Romania. Life (Basel). 2026; 16(6): 957. DOI: https://doi.org/10.3390/life16060957
Dorf N, Maciejczyk M. Skin manifestations in diabetes—what is new? Front Med (Lausanne). 2025; 12: 1640144.
DOI: https://doi.org/10.3389/fmed.2025.1640144
Abate MCMO, Aroucha PMT, Nóbrega DVM, Rocha IPM, Soares SD, Reis AA, et al. Cutaneous manifestations of diabetes mellitus: A narrative review. Einstein (Sao Paulo). 2025; 23: eRW1193. DOI: https://doi.org/10.31744/einstein_journal/2025rw1193
Ly L, Vo KL, Cruel AC, Shubrook JH. Dermatological manifestations of diabetes mellitus and its complications. Diabetology. 2025; 6(3): 18. DOI: https://doi.org/10.3390/diabetology6030018
David P, Singh S, Ankar R. A comprehensive overview of skin complications in diabetes and their prevention. Cureus. 2023; 15(5): e38961. DOI: https://doi.org/10.7759/cureus.38961
Chen VY, Siegfried LG, Tomic-Canic M, Stone RC, Pastar I. Cutaneous changes in diabetic patients: Primed for aberrant healing? Wound Repair Regen. 2023; 31(5): 700-12. DOI: https://doi.org/10.1111/wrr.13108
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