DIABETES INDUCED DERMATOLOGICAL MANIFESTATIONS AND THEIR ASSOCIATION WITH VASCULAR COMPLICATIONS
DOI:
https://doi.org/10.55519/JAMC-S4-14506Keywords:
Diabetes mellitus, dermatological manifestations, vascular complications, diabetic dermopathy, necrobiosis lipoidica diabeticorum, coronary artery disease, diabetic retinopathy.Abstract
Background: Diabetes related skin diseases, microvascular complications or metabolic alterations are affecting a majority of diabetic individuals. The purpose of this study was to identify the proportion of patients who presented with dermatological manifestations and to determine associated macrovascular and microvascular complications such as CAD, LEAD and Diabetic retinopathy. Methods: The present study was a cross-sectional descriptive survey with 355 T2DM. Participants were divided into two groups: to compare the incidence of skin manifestations and their association with cardiovascular complications between the patients with dermatological manifestations (n = 136) and those without (n = 219). Demographic data and clinical data regarding HbA1c, diabetes duration, and treatment method of patients with type 2 diabetes were also assessed. Skin inspection detected findings such as diabetic dermopathy, presence of Huntley’s papules, and necrobiosis lipoidica diabeticorum. Vascular complications were ascertained clinically and by imaging. The data was analyzed by using descriptive and inferential tools chi-square test, independent sample t-test as well as logistic regression. Results: Diabetes induced dermatological manifestations (DDMs) were observed in 38, 3% of the patients with diabetic dermopathy as the most frequent condition in this study with Huntley’s papules and necrobiosis lipoidica diabeticorum following the same trend. The number of vascular complications were significantly higher in patients with DDMs compared to those without DDMs patients. CAD was detected in 28.8% of the patients with DDMs as compared to 18.2% without DDMs (p=0.008). LEAD was detected in 35.5% of patients with DDMs compared to 23.5% of those without DDMs; p<0.001. Choroidal detachment and retinopathy of 10.5% were more common in patients with DDMs compared to those without 4.0% (p=0.003). Necrobiosis lipoidica diabeticorum was strongly associated with diabetic retinopathy and nephropathy, with an odds ratio (OR) of 5.11 (p<0.001). Multivariable analysis confirmed that the presence of DDMs was an independent predictor of vascular complications with OR: 2.35 (p<0.001). Conclusions: The three DDMs; diabetic dermopathy, Huntley’s papules, and necrobiosis lipoidica diabeticorum are strongly linked with vascular complications in T2DM patients. Dermatological screening should be incorporated into the usual diabetes care to enable early assessment of patients with increased potential for developing vascular complications that affects their prognosis.
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