Skin changes in patients with diabetes mellitus in Karlovac county

Abstract

Cilj: Istražiti proporciju dermatoza koja su vezane uz diabetes mellitus (DM) i onih koje su nepovezane s njime, proporciju pojedinih skupina u odnosu na ukupan broj dermatoza povezanih s dijabetesom, proporciju s obzirom na spol i proporciju s obzirom na vrstu dijabetesa u pojedinim skupinama. Bolesnici i metode: Retrogradnom studijom obuhvaćeni su bolesnici dijabetološke ambulante pregledani 2007. godine, a imali su kožne promjene i bili na pregledu u dermatološkoj poliklinici. Ukupno je u ambulanti za dijabetes bilo 754 bolesnika s dijabetesom. Rezultati: Ukupno je nađeno da 131 bolesnik (17,37%) ima dijabetes i jedno od dermatoloških stanja od čega 84 bolesnika (55,24%) s dermatozom povezanom s dijabetesom i 47 bolesnika (44,76%) s kožnim promjenama nepovezanim s dijabetesom. Ukupno je 21 bolesnik (16,03%) imao o inzulinu ovisan dijabetes, a 110 bolesnika (83,97%) o inzulinu neovisan dijabetes. Kod dermatoza povezanih s dijabetesom najčešća je prva skupina kod koje postoji veća ili manja povezanost s dijabetesom s ukupno 58 bolesnika (69,06%). Najčešća je bila dijabetička dermopatija kod 27 bolesnika (32,14%), a zatim fibromi kod 9 bolesnika (10,71%). U drugoj skupini infekcija povezanih s dijabetesom bilo je 13 bolesnika, što čini 16,47% svih bolesnika, a najčešće su bile mikoze kod 8 bolesnika (9,52%). Dijabetičkih komplikacija bilo je kod 11 bolesnika (13,10%) i to ulkusi kod 4 bolesnika (4,76%) i kseroza kože kod četiri bolesnika (4,76%). Rasprava i zaključak: Naši rezultati slični su rezultatima drugih autora u razvijenom dijelu svijeta gdje prevladavaju neinfektološke kožne manifestacije dijabetesa. Rano otkrivanje i adekvatno liječenje ne samo povišene glikemije nego i svih ostalih promjena kod dijabetičara vrlo je značajno, kako zbog kvalitete života tako i zbog opće prognoze bolesti. Kožne manifestacije dijabetesa kao najčešće i vrlo lako vidljive moraju imati veće značenje u multidisciplinarnom i timskom pristupu liječenja dijabetesa.Aim: To invastigate the proportion of skin diseases in specific population of patients with diabetes mellitus (DM) with special regards to skin changes associated with diabetes. We also analyzed the proportion of dermatoses in four main groups of skin diseases associated with diabetes and distribution according to sex and type of diabetes. Results: In diabetic outpatient clinic during the year 2007 there were 754 patients diagnosed with diabetes. Skin changes were present in 113 (17,37%) of 754 patients, changes associated with diabetes in 84 (55,24%) patients and skin disease not associated with diabetes in 47 (44,76%) patients. According to different types of diabetes 21 (16,03%) patients had insulin dependent DM and 110 (83,97%) patients had non-insulin dependent DM. The first group of skin disease more or less associated with diabtes mellitus was the most common in 58 patients (69,06%). In this group diabetic dermopathy was the most common (27 patients or 32,14%). The second group were skin infections asscociated with diabtes mellitus and were found in 13 patients (16,47%). The most common was mycosis in 8 (9,52%) patients. Third group represented diabetic complications, was found in 11 patients (13,10%) and the most common changes were ulcers in 4 (4,76%) patients and xerosis cutis in 4 (4,76%) patients. Allergic and other reactions on antidiabetic medications were recorded in only 2 patients (2,38%). Discussion and conclusion: Our results are similar to results from other studies from developed countries where non-infectuous dermatoses are highly prevalent in diabetic patients. Early detection and therapy of high glucose level and also skin changes are of great interest for the patient’s benefit. Skin manifestations present in diabetic patients are very common and easy visible so it is very important to be able to recognize specific dermatoses associated with diabetes and to treat them with close cooperation of dermatologist and diabetologist in multidisciplinary and team approach

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