Skin itching in type 1 and type 2 diabetes mellitus

Diabetes mellitus is a dangerous and unpleasant disease that not only causes discomfort to a person, but also significantly limits its vitality. One of the most unpleasant phenomena, many patients recognize itching in diabetes. Itching can be strong, bothersome. Sometimes it becomes unbearable and practically brings a person to a nervous strain.

Is it pruritus in diabetes mellitus?

Diabetes is very often accompanied by itching, as this disease is based on the violation of metabolic processes. This entails an increased burden on all systems, including, on the nervous system, endocrine, immune. As a result, the sensitivity and susceptibility of the organism develops. Sometimes itching is a consequence of an allergic reaction that develops against the background of metabolic disturbances.

Causes of the itching of the skin in diabetes

There can be many reasons. First of all, these are internal processes that take place in the body. It can be allergic, autoimmune diseases, disruption of the normal functioning of the nervous and endocrine system. In some cases, the cause may be a congenital hypersensitivity of the nervous system, as well as a violation of the general biochemical cycle, including obesity, malnutrition and other processes.

Risk factors

The risk group includes people suffering from disorders of the immune, endocrine, nervous system, suffering from excessive or underweight. Risk factors include both excessive and inadequate nutrition, impaired metabolic processes, malnutrition, lack of vitamins and minerals in the body, and inadequate drinking. Also, people who use excessive amounts of sweet, eat fatty, smoked, fried foods that contain large amounts of cholesterol are at risk. 

[1]

Pathogenesis

At the heart of pathogenesis is a violation of the general processes in the body, and as a result, violations at the local level. In this case, excessive amounts of glucose are accumulated in the blood. Kidneys are not able to process excessive amounts of sugar entering the body with food. Or the cause may be a violation of kidney function, in particular, its absorption processes. This leads to excessive accumulation of fluid in the body. Together with it, toxins and metabolic products accumulate, which have a negative effect on further metabolic processes. Intoxication increases, at the local level, tissue and cell exchanges are disturbed.

There is also a violation of the hormonal background. In particular, the function of the adrenal gland and pancreas. As a result, the hormonal background is significantly disturbed, including the mechanism of regulation of carbohydrate metabolism, which manifests itself in the violation of the exchange of sugars.

Gradually accumulates an excessive amount of glucose (as the final product of carbohydrate metabolism in the body). Glucose accumulates in the cells, leaves the intercellular space, which leads to a change in the total carbohydrate metabolism. As a result, the process can stop at this, and can worsen, which will lead to the progression of the disease. Excessive accumulation of glucose leads to disruption of the local circulation.

[2], [3],

Epidemiology

According to statistics, diabetes mellitus occurs mainly in people older than 60 years. Nevertheless, today there is a tendency to rejuvenate the disease: it occurs even in people aged 55-60 years. Sometimes diabetes occurs in the younger generation, and even in children. Thus, the incidence among elderly people accounts for about 65% of the disease, in people under 60 years of age this disease accounts for about 25% of the incidence, the youth age accounted for 6% and about 4% falls on children under the age of 10 . At the same time, approximately 68% of cases of diabetes are accompanied by severe itching. The itch most often disturbs children and young men (78% of cases), 15% of cases are in people of mature age and only 3% are in the elderly.

[4], [5], [6], [7], [8]

Symptoms

As a first sign is a strong burning and itching. At the same time, irritation occurs on the skin, in any place. The skin can be dry, tightened, peeling and roughness appear. Gradually the skin can slazit. Often in the area of the hair, dandruff develops.

What is itching for diabetes?

Itching, as a rule, can be characterized as permanent, intrusive. He often prevents sleep, as it can cause nervous overexertion, and even a nervous breakdown. This also causes burning, redness, irritated areas. Particularly worse at night. In the evening it becomes stronger, it tends to decrease by morning.

With diabetes, the skin suffers a lot. On it there are various eruptions, irritations, which are accompanied by itching. There are also cases in which the skin is absolutely clean, without any rashes and irritations. However, the itching is a huge concern. 

[9], [10]

Itching of the body with diabetes

Diabetes is often accompanied by itching. Not only the head, arms, legs, but also the entire body is scratched. In most cases, the cause of pruritus are allergic reactions, excessive accumulation in the body of metabolic products, toxins. Also, itching may occur due to an allergic reaction. Hypersensitivity to the skin, sensitization of the body, excessive glucose in the blood can lead to the development of itching. Often itching is accompanied by a rash, redness of the skin, irritation.

Itching in the intimate area with diabetes mellitus

The cause may be a change in the total hormonal background, as well as an increased level of glucose in the blood. All this leads to a disruption of the normal state of the microflora on the mucous membranes of the urogenital tract. This leads to the development of irritation, inflammatory process. In this case, under the influence of increasing titer of glucose, irritation of the mucosa increases, which leads to reddening, itching, and the appearance of an unpleasant odor. Itching can develop as a result of the appearance of abundant secretions that accompany any inflammatory and infectious process.

The danger of itching in the perineum, genitals and anus is that it is almost always accompanied by intensive development of fungal and bacterial infections. High blood glucose levels undermine human immunity, so the immunity of a diabetic patient is reduced a priori. Also, all patients have hormonal disorders. Any infection progresses against a background of reduced immunity. The inflammatory process is also progressing.

First of all, women suffer from itching of the genital organs, as this is facilitated by features of the anatomical structure of female genital organs, as well as certain functional features and physiological needs of the female body.

A dangerous complication of pruritus in intimate places is the development of a fungal infection. Most often, candidiasis develops, which is also called thrush. Candidiasis is caused by a fungal infection - a Candida fungus. The mechanism of infection is as follows: blood glucose levels increase. This entails a decrease in immunity, a violation of the hormonal background. As a result, a violation of microflora develops. First of all, the microflora of the urogenital tract is disturbed, since this is the most dynamic biotope.

Disturbance of microflora entails a dysbacteriosis, in which the amount of normal microflora decreases and the amount of pathogenic microflora increases. It can be a bacterial infection, a fungal infection.

Itching of the feet with diabetes

Quite often itching affects the legs. This is due to the fact that the main burden falls exactly on the feet of any person. It is known that diabetes is accompanied by an increase in the amount of glucose in the blood. This entails a number of negative consequences, such as a violation of the normal state of the vessels, a decrease in the rate of blood circulation, a violation of the circulatory processes, a decrease in the elasticity and elasticity of the vessels. All this negatively affects the condition of the vessels of the legs in the first place. As an aggravating factor is the possible varicose veins, the development of atherosclerosis.

Itching and burning with diabetes

These symptoms most often affect the legs, crotch, groin, head. Sometimes itching and burning of the whole body. The cause of the development of itching and burning is a violation of the normal functioning of the immune system, a violation of the hormonal background, the development of dysbiosis. All this is accompanied by a violation of normal metabolism, in particular, the carbohydrate metabolism is disrupted. As a result of such disorders, excessive accumulation of glucose in the blood takes place. This continues to disrupt metabolism, promotes the accumulation in the body of metabolites, circulating immune cells.

The increased amount of glucose in the blood contributes to the development of inflammatory and infectious reactions, negatively affects the condition of blood vessels. Their elasticity and flexibility are lost. Exudate, inflammatory and infectious process may develop. Irritation and redness often occurs on the surface of the body, which causes itching and burning.

Itching in the groin and perineum with diabetes

Diabetes mellitus is accompanied by itching, which occurs most often in the perineum and in the inguinal region. Providing adequate treatment, getting rid of itching is easy enough. If the symptom is not treated, then more serious complications may develop, in particular, the itching passes into a burning condition, or into a chronic condition. Sometimes itching passes from the groin to the whole body. Often the cause is an increased level of glucose in the blood. The development of it can increase under the influence of stress, in the sun, with age. Therefore, it is important for diabetics to control the level of glucose in the blood.

Itching is not always due to high blood glucose. It must be ensured that it is not the result of environmental factors. So, itching can be a skin reaction to various stimuli, unfavorable factors. Negatively affects also ultraviolet, some cosmetics. Itching can be caused by the negative impact of new technologies, skin care products, epilation techniques. It is often confused by the itching that occurs after using the epilator, or by performing cosmetic procedures with itching, which occurs as a result of metabolic disorders in the background of diabetes.

Various diseases of internal organs can cause the development of pruritus. Inflammation is a natural reaction to the destructive processes that occur in the body under the action of a high level of glucose. This is also due to the fact that the load on the body, on the main organs and systems is significantly increased. For example, diabetes is most often accompanied by itching, which is observed in diseases of the kidneys, liver, adrenal and pancreas.

Itching and burning can be a consequence of hypovitaminosis. Particularly pronounced with a deficiency of vitamins A, PP, C Quite often the cause is allergic reactions, skin irritation with synthetic tissues. This can be especially pronounced in women who wear nylon tights. They have a high degree of electrification, as a result of which they can disrupt microcirculation and air exchange, which leads to the development of itching, additional burning. This includes poor nutrition, frequent stresses, impaired metabolic processes.

It should be borne in mind that the sensitivity of the skin in diabetes significantly increases. The reasons can be various: the itch develops at disturbance of local blood circulation, squeezing of certain sites by close clothes, accessories. Thus, the causes of pathology can be many, and it is impossible to determine the exact cause without conducting a diagnosis. Therefore, you need to contact the doctor as soon as possible, who will prescribe the necessary examination, diagnose and prescribe adequate treatment.

Itching of the head with diabetes

The head is often itchy with diabetes, and there can be many reasons for this. The exact cause of the development of the itch of the head is not known to anyone yet. So, we can assume that the itching develops as a result of reduced immunity, against the background of disturbed metabolic processes. In particular, this concerns violations of carbohydrate metabolism. It is known that itching also develops against the background of intoxication, increased stress on the body, allergization and sensitization of the body. It should also be taken into account that the sensitivity of the skin significantly increases against the background of increased glucose.

Itching in the anus in diabetes

The back passage can be itchy, as sensitization and sensitivity of the body increase. It is also necessary to conduct differential diagnosis, making sure that it is not helminthous and not other diseases of an invasive nature. Also it is necessary to exclude allergic reaction, intoxication. To do this, you need to visit a doctor who will perform the diagnosis and prescribe the necessary treatment. Laboratory and instrumental diagnostics are used as tests. Quite informative can be blood tests (biochemical, clinical, blood for sugar), urine and feces analysis, as well as scraping.

Severe itching in diabetes

When there is severe itching, it is necessary to carry out a diagnosis, since there can be many causes, and the treatment of itching is predominantly etiological, that is, aimed at eliminating the main causes of pathology development.

In order to diagnose the disease, you need to see a doctor as soon as possible. It will take an inspection, a survey. The doctor during the interview collects an anamnesis of life and illness, in the analysis of which many important information can be obtained. It is the interview and the history that help the doctor determine the exact cause of the pathology.

Having received all the necessary information, the doctor can already judge the causes of the development of the disease, the features of pathogenesis, clinical forms, make certain predictions. Then the doctor examines the patient. Usually classical methods of research are used, such as palpation, percussion, auscultation. If necessary, laboratory and instrumental methods of investigation may be prescribed, which depend on the organ in which the possible pathology is located.

With severe itching, it is almost always necessary to have additional diagnostics in the form of tests, instrumental diagnostics. The most commonly prescribed clinical tests: blood, urine, feces. They allow us to assess the overall orientation of the processes occurring in the body. Based on these general data, it is possible to determine the course of further diagnosis, depending on which pathology is assumed. Additional tests may be prescribed.

Also take smears, scraping directly from the itching site. With a disease of unclear etiology, a study is conducted on hidden infections, parasitic diseases. Instrumental diagnosis depends on what pathology the doctor suspects. For example, if you suspect a GI disease, you may need a gastroscopy, a radiography, an ultrasound, a colonoscopy. If you suspect a respiratory system, a spirogram, an X-ray, functional tests are performed. If there is a suspicion of heart disease and circulatory system, an electrocardiogram, ultrasound of the heart and other examinations are prescribed.

The most global method of investigation is magnetic resonance imaging, which allows to assess the condition of the osseous system and soft tissues. The scale of the procedure is such that it is possible to investigate the whole organism as a whole. The advantage of the method is that it allows to identify possible pathologies at the earliest stages of their formation, which makes it possible to take the necessary measures in time and eliminate pathologies in the early stages, or to prevent it.

Itching in men with diabetes

In men, itching develops less often than in women. However, in terms of intensity, it is much stronger and more intrusive, getting rid of it is more difficult. Therefore, it is important to prevent itching, or to stop its progression in the early stages. Diagnostics is important for this.

First of all, you need to determine whether the itch is an independent manifestation of any skin disease, allergic or other reaction, or is a symptom of diabetes. For this, laboratory and instrumental diagnostics are carried out.

It is also important to determine the exact cause of the itching. The simplest method of treatment is etiologic, aimed at eliminating the cause of pathology. The faster the cause is eliminated, the faster the disease will be cured.

Itching in women with diabetes

In women, itching develops mainly in the urogenital tract, urogenital organs, because it is the most vulnerable part of the woman's body. This is due to the peculiarities of the anatomical structure and physiology of the female body, the state of the immune system and the hormonal background. In order to cure the itching, you need to see a doctor. It may be necessary to consult a gynecologist-endocrinologist.

Itching of the vagina with diabetes

The main cause of the development of this pathology, most often is a vaginal dysbiosis, against which the amount of normal microflora is reduced. This place immediately takes pathogenic microflora, which leads to the development of the inflammatory process.

Any infection usually develops against a background of reduced immunity, which develops against the background of hormonal disturbances, metabolic disorders, vitamin deficiency. Dysbacteriosis also acts as one of the factors that disturbs the state of the mucous membrane and microflora.

The basis of the biotope of the female reproductive system is represented by vaginal bioavariants of saccharolytic microorganisms. They are called "Dodderlein" bacteria. The development of these microorganisms is accompanied by intensive synthesis of lactic acid. This acid forms the optimal environment, which promotes the development of representatives of normal microflora.

Also important is the fact that such a medium prevents the colonization of the biotope by acid-sensitive microorganisms, which are most often pathogens. This property is called colonization resistance, the essence of which is that representatives of normal microflora do not allow the representatives of pathogenic flora to develop. If the blood glucose level increases, the environment also changes: the hormonal background changes, immunity decreases, and the natural environment in various biotopes varies. This entails a change in the bacterial population, the main representatives. As a result, the number of lactobacilli decreases, and their place is occupied by other organisms that are pathogenic or conditionally pathogenic. They can cause irritation, puffiness, itching, disease.

Diagnostics of the itching of the skin in diabetes

In order to differentiate the itch caused by diabetes, from other diseases, you must first establish a diagnosis. The diagnosis is based on the clinical picture of the pathology, as well as data from diagnostic studies. If necessary, differential diagnosis is performed.

So, it is characterized by polyuria, thirst, increased appetite and at the same time emaciation, periodontosis, flaccid wound healing, furunculosis. Often the leading symptom is the itch, which helps to identify the disease. Sometimes there is pain in the legs. In general, the diagnosis of diabetes is simple and possible even after accidental determination of the sugar level in urine or blood. It happens to be asymptomatic, but with a lot of hyperglycemia (over 6.66 mmol / l), which is determined on an empty stomach and with a typical glycemic curve.

Itching occurs as a result of skin lesions that are nonspecific. For example, sometimes on the skin as a result of the expansion of the vessels of the capillary system, there is a blush on the cheeks, upper eyelids. On palms appears yellowness, is caused by a violation of synthesis in the liver of vitamin A. High concentration of glucose in the skin causes damage to her pustular and fungal diseases. With decompensated diabetes, the skin becomes dry, the wounds heal slowly. Violated trofika tknaey6 intense keratinization of the skin of the feet, a thickening of the nails.

Vascular lesions at all levels, in particular nephopathy, are noted. In this case, the capillaries change aneurysmatically, the main membrane changes (towards the thickening), lipids, glycogen are deposited in the intima. Microangiopathies are observed in young patients, after 30-40 years, microangiopathies are added to the indicated shifts.

[11], [12], [13], [14], [15]

Analyzes

Significant is the sugar content in the urine. The determination is carried out with a glucose oxidant assay according to Nylander. In the presence of glucose in the urine, yellow litmus paper stains blue. The determination of ketone bodies in the blood is performed by iodometric and colorimetric method. In blood in healthy people, they are usually contained within 146.2-172 μmol / l. The determination of acetone in urine is most often performed with the help of indicator tablets.

[16], [17], [18], [19], [20], [21], [22], [23]

Instrumental diagnostics

A test of glucose tolerance makes it possible to detect a change in the incretory function. At the same time, the fasting sugar level is determined and every 30 minutes for 2-3 hours after taking 50 grams of glucose dissolved in 200 grams of water. If glucose tolerance is violated after an hour of exercise, the glycemia is higher than 11.11 mmol / L and after 2 hours exceeds 8.32 mmol / l.

Samples with a double load of glucose according to Staubu-Traugott differ from the previous study by repeated administration of glucose 90 minutes after the first. In healthy individuals, the sugar curve under such a load is characterized by a single peak of glycemia 30 minutes after the first load and returning to normal glycemia after 2-3 hours. In violation of carbohydrate metabolism, two peaks of glycemia are detected.

If there is a suspicion of impaired glucose absorption in the intestine, a test is performed with intravenous glucose. Glycemia on an empty stomach and every 10 minutes for 1.5 hours after a slow injection of 10 ml of 50% glucose solution. In healthy individuals, the sugar content in the blood returns to normal after 90-120 minutes, while in diabetics it remains elevated.

Glycocorticoid test is based on the fact that glycocorticosteroids increase the need for tissues in insulin. Strengthening neoglycolysis in the liver, they lead to a more significant increase in glycemia in persons with inferior insular apparatus. This test is carried out in individuals up to 45 years of age 2-3 days after a normal normal test for glucose tolerance. For 8 and 2.5 hours before taking 50 grams of glucose, the subject takes 50 grams of cortisone or 10 mg of prednisalone. Then the glycemic curve is examined for 2 hours. In healthy individuals, glycocorticosteroids do not affect the level of glycemia.

Differential diagnosis

It should be performed with renal glucosuria, renal diabetes, alimentary glucosuria, bronze and diabetes insipidus.

Renal diabetes occurs due to genetic defects in the mechanism of glucose reabsorption - the lack or decrease in activity of enzymes of hexokinase and alkaline phosphatase.

Bronze diabetes is a serious liver disease. To confirm the diagnosis, watch the amount of serum iron, examine liver and skin biopsy samples.

[24], [25],

Treatment of the itching of the skin in diabetes

Treatment of itching is predominantly etiological, that is, it is aimed at eliminating the cause of pathology. First, it is necessary to cure the underlying disease - actually diabetes, and the itching, as one of their symptoms, will disappear on its own. Complex treatment is applied, which is aimed at normalization of all types of metabolic processes. Includes diet and hypoglycemic drugs, insulin replacement therapy.

Complications and consequences

Itching can be complicated by intense spread to other parts of the body, as well as throughout the body. Itching can be difficult to fight. Also, one of the complications can become skin irritation, development of rash, spots, redness, peeling and various skin diseases. Also as a complication, allergic reactions are considered. Itching in diabetes can be accompanied by pain, burning.

[26], [27], [28]

Prevention

Reduced to the prevention and elimination of diabetes, as a major disease. The main way to treat and prevent any form of diabetes is diet. Treatment with a single diet is prescribed for people with impaired glucose tolerance and with a mild diabetes mellitus. Assigning a diet with reduced or reduced caloric content, you can increase or decrease the body weight of patients.

Often, a decrease in the body weight of diabetic patients suffering from obesity leads to a normalization of carbohydrate metabolism. The amount of carbohydrates is reduced. Instead of glucose, it is recommended to use xylitol, sorbitol, saccharin. The amount of protein, on the contrary, is increased, as it decays strongly. It should be borne in mind that its increase can cause the appearance of metallic taste in the mouth, as well as irritation of the food canal and kidneys. Protein should be limited only if the kidneys are affected with signs of retention of nitrogenous slags, as well as in a coma. To prevent dehydration, do not limit the amount of liquid.

[29], [30]

Forecast

In general, the outlook is favorable. Itching in diabetes is cured completely if diabetes can be cured. If diabetes is not treated, itching will not only disappear, but will also progress.