Skin disorders in patients with diabetes mellitus: a review

2021 ◽  
pp. 54-65
Author(s):  
C. Diehl
Keyword(s):  
Diabetes Mellitus ◽  
Extracellular Proteins ◽  
Diabetic Patients ◽  
World Population ◽  
Skin Disorders ◽  
Limited Joint Mobility ◽  
Systemic Complications ◽  
Cutaneous Infections ◽  
Dermal Collagen

Diabetes mellitus (DM) is a frequent metabolic disease whose prevalence is estimated to be around 9.3 % in the world population in the age group 20—79, corresponding to 463 million affected subjects. Moreover, this prevalence will probably increase in the course of the next years. It accounts for more than 90% of the diabetic patients. Besides systemic complications, those ay also be observed in dermatology. According to the region, the prevalence of skin disorders in patients suffering DM is ranging from 35.4 to 98.8 %. This makes these symptoms a frequent cause of consultation in dermatological practice. The most occurring disorders are skin infections, but yellow nails, candidiasis, acrochordons, limited joint mobility and idiopathic guttate hypomelanosis may also be frequently observed. Diabetic dermopathy and diabetic foot syndrome are also common, such as pigmentation disorders such as acanthosis nigricans and vitiligo. Differences between patterns of lesions remain unclear among types of DM (type 1 or type 2). Overall, cutaneous infection and xerosis showed to be highly prevalent and important skin disorders in several studies, regardless DM type. Among cutaneous infections, fungal aetiology appears to be the most common and those with bacterial origin are the less frequent.DM affects the skin through several mechanisms — High levels of glycaemia strongly affect skin homeostasis by impairing the normal functioning of keratinocytes in vitro, decreasing their proliferation and differentiation. They also lead to advanced glycation end products (AGEs) formation. The latter are formed from glycation of proteins, lipids and nucleic acids. They have various deleterious effects at skin levels: inducing reactive oxygen species (ROS) formation, impairing ROS clearance, as well as intra and extracellular proteins function, and inducing pro inflammatory cytokine through nuclear factor κβ (NF-κβ) pathway. AGE alters collagen properties, decreasing flexibility and solubility and increasing its rigidity, thickening dermal collagen, with increased cross linking from non-enzymatic glycosylation, participating in the development of fibrosis. In diabetic patients, the vascular changes found in the skin are similar to those caused by UV-exposure, i. e. thickening of the vessels walls, increasing from thigh to foot and most marked in the capillaries and leading to failure of vascular responsivenessThis paper is aimed to summarize all these pathologies, reporting their prevalence, giving a brief description of the symptoms, of their pathogenesis and guidelines for their management. Dermatologists have a key role in their treatment, but also in detecting new cases of DM when taking in charge these pathologies. They must also promote glycaemic control by these patients.

scholarly journals LIMITED JOINT MOBILITY IN A CHILD WITH TYPE 1 DIABETES MELLITUS.

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Mohammad H. Al-Qahtani ◽  
Fai A. AlQahtani
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Warning Sign ◽  
Diabetic Patients ◽  
Joint Mobility ◽  
Limited Joint Mobility ◽  
Systemic Complications

Chronic uncontrolled type 1 diabetes mellitus (type 1DM) is a very major risk for chronic systemic complications; specifically, the microvascular and macrovascular ones. Limited joint mobility (LJM) is a rare disease that complicates all types of diabetes and might indicate the high-risk odd for the diabetic patients to develop microvascular complications. We are reporting a 13-year-old female child with chronic uncontrolled type 1DM presenting with full blown clinical picture of bilateral hand LJM associated with significant growth failure yet has no clinical or biochemical evidence of microvascular complications. Literature research studies have emphasized the rarity of this manifestation in pediatric type 1 diabetic patients; however, it is an important clue and warning sign for microvascular complication occurrence in these patients.

scholarly journals The Functionality of Endothelial-Colony-Forming Cells from Patients with Diabetes Mellitus

Cells ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 1731
Author(s):  
Caomhán J. Lyons ◽  
Timothy O'Brien
Keyword(s):  
Diabetes Mellitus ◽  
Cell Therapy ◽  
Diabetic Patients ◽  
Angiogenic Potential ◽  
Endothelial Colony Forming Cells ◽  
Allogeneic Cell Therapy ◽  
Patients With Diabetes ◽  
Pre Treatment

Endothelial-colony-forming cells (ECFCs) are a population of progenitor cells which have demonstrated promising angiogenic potential both in vitro and in vivo. However, ECFCs from diabetic patients have been shown to be dysfunctional compared to ECFCs from healthy donors. Diabetes mellitus itself presents with many vascular co-morbidities and it has been hypothesized that ECFCs may be a potential cell therapy option to promote revascularisation in these disorders. While an allogeneic cell therapy approach would offer the potential of an ‘off the shelf’ therapeutic product, to date little research has been carried out on umbilical cord-ECFCs in diabetic models. Alternatively, autologous cell therapy using peripheral blood-ECFCs allows the development of a personalised therapeutic approach to medicine; however, autologous diabetic ECFCs are dysfunctional and need to be repaired so they can effectively treat diabetic co-morbidities. Many different groups have modified autologous diabetic ECFCs to improve their function using a variety of methods including pre-treatment with different factors or with genetic modification. While the in vitro and in vivo data from the literature is promising, no ECFC therapy has proceeded to clinical trials to date, indicating that more research is needed for a potential ECFC therapy in the future to treat diabetic complications.

scholarly journals Melatonin Ameliorates MI-Induced Cardiac Remodeling and Apoptosis through a JNK/p53-Dependent Mechanism in Diabetes Mellitus

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Linhe Lu ◽  
Jipeng Ma ◽  
Mingming Sun ◽  
Xiaowu Wang ◽  
Erhe Gao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Interstitial Fibrosis ◽  
Myocardial Dysfunction ◽  
Cardiac Injury ◽  
Diabetic Patients ◽  
High Fat ◽  
Adult Mice ◽  
Cardiac Geometry ◽  
And Function

Diabetes mellitus, a worldwide health threat, is considered an independent risk factor for cardiovascular diseases. The overall cardiovascular risk of diabetes is similar to the one having one myocardial infarction (MI) attack although the precise impact of diabetes on MI-induced myocardial anomalies remains elusive. Given that mortality following MI is much greater in diabetic patients compared to nondiabetic patients, this study was designed to examine the effect of melatonin on MI injury-induced myocardial dysfunction in diabetes. Adult mice were made diabetic using high-fat feeding and streptozotocin (100 mg/kg body weight) prior to MI and were treated with melatonin (50 mg/kg/d, p.o.) for 4 weeks prior to assessment of cardiac geometry and function. The MI procedure in diabetes displayed overt changes in cardiac geometry (chamber dilation and interstitial fibrosis) and functional anomalies (reduced fractional shortening and cardiomyocyte contractile capacity) in association with elevated c-Jun N-terminal kinase (JNK) phosphorylation and p53 level. Melatonin treatment markedly attenuated cardiac dysfunction and myocardial fibrosis in post-MI diabetic mice. Furthermore, melatonin decreased JNK phosphorylation, reduced p53 levels, and suppressed apoptosis in hearts from the post-MI diabetic group. In vitro findings revealed that melatonin effectively counteracted high-glucose/high fat-hypoxia-induced cardiomyocyte apoptosis and contractile dysfunction through a JNK-mediated mechanism, the effects of which were impaired by the JNK activator anisomycin. In summary, our study suggests that melatonin protects against myocardial injury in post-MI mice with diabetes, which offers a new therapeutic strategy for the management of MI-induced cardiac injury in diabetes.

scholarly journals Dermatological Manifestations in Diabetes Mellitus at NGMCTH Kohalpur

2017 ◽  
Vol 13 (2) ◽  
pp. 31-34
Author(s):  
Sumit Pandey ◽  
Pradip Mishra ◽  
Nirmala Sharma ◽  
Shyam B.K.
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Disease ◽  
Teaching Hospital ◽  
College Teaching ◽  
The Body ◽  
Diabetic Patients ◽  
Cutaneous Infections ◽  
Medical College ◽  
Patients With Diabetes ◽  
Sugar Levels

Background: Skin is the largest and most visible organ in the body. It undoubtedly determines to a great extent our appearance and plays  a  major  role  in  socio-sexual  communication.  More  than  one  third  of  diabetic  patients  have  some  type  of  dermatologic 1 manifestations during the course of their chronic disease . The association of certain skin diseases with diabetes mellitus has been 2 3 fairly well recognized with an incidence rate ranging from 11.4% to 66%.  At least 30% of patients with diabetes mellitus have some 4 5 type of cutaneous involvement during the course of their chronic disease.  Skin sugar levels run parallel to the blood sugar levels. Skin changes generally appear subsequent to the development of DM but may be the first presenting sign or even precede the 6 diagnosis by many years. Among the many skin manifestations in DM, none is pathognomonic of this disease. Cutaneous findings in DM can be classified into four categories: (1) skin disease with strong association and others with less distinct association with DM, (2) cutaneous infections, (3) dermatological disorders related to diabetic complications, and (4) skin conditions related to diabetes 7 treatments.Objectives: This study was undertaken to find out the pattern of Dermatological manifestations in Diabetes patients attending Nepalgunj Medical College Teaching Hospital, Kohalpur. Method and material: This is a hospital- based descriptive study conducted  in  the  Department  of  Dermatology,  Venereology  and  Leprology  of  Nepalgunj  Medical  College  Teaching  Hospital, Kohalpur  between   September 2013 to August 2014.  A total of 100 patients were included in the study. History and clinical examinations were performed and the data were recorded and analyzed. Results: The age of the patients ranged from 20 years to 85 years with the mean age of 51.7+12.13 years. The most common age groups were 46-55 years (36%) followed by 56-65 years (24.7%) and 36-45 years (17.3%), 66-75 years (9.3%), 76-85 years (12.7%). Among the 100 patients of diabetes ellitus, there were 44(44%) males and 56 (56%) females.  Among  the  cutaneous  disorders  commonly  associated  with  diabetes,  infections  were  the  most prevalent. 59(59%) out of 100 patients had skin infections.Conclusions: Patients with Diabetes can present with array of cutaneous disorders. Cutaneous infections formed the largest group of dermatoses in this study. Increased incidence of cutaneous infections mainly fungal and bacterial was noticed in majority diabetics emphasizing the need for more aggressive management of diabetes mellitus. Among infective dermatoses, fungal infections were the most common, with Candidal infections being more common than dermatophytosis.JNGMC Vol. 13 No. 2 December 2015, Page: 31-34

scholarly journals Cutaneous manifestations of diabetes mellitus: a clinical study

2018 ◽  
Vol 4 (3) ◽  
pp. 352
Author(s):  
Nancy Bhardwaj ◽  
Samarjit Roy ◽  
Rashmi Jindal ◽  
Sohaib Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Diabetic Control ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Cutaneous Manifestations ◽  
Female Ratio ◽  
Cutaneous Infections

<p class="abstract"><strong>Background:</strong> Diabetes mellitus is a leading cause of morbidity with adverse effects on various systems including skin. Cutaneous manifestations seen in diabetes aid in its diagnosis and some of them may also correlate with diabetic control, duration and other complications. This study was undertaken to estimate burden of skin disorders among diabetics in a tertiary care centre of Uttarakhand.</p><p class="abstract"><strong>Methods:</strong> The study was conducted at Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India, over a period of one year from January 2016 to December 2016. Three hundred and seventy seven patients irrespective of age and sex were included in the study and those with gestational diabetes were excluded. Patients were examined for mucocutaneous manifestations and evaluated. Structured case reporting form was used to generate data.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 377 patients studies, 114 (30.2%) were in the age group of 51-60 years. Male to female ratio was 1.44:1. Mucocutaneous manifestations were present in 278/377 (73.7%) patients. Common cutaneous manifestations were cutaneous infections [fungal infections (n=106/377; 28.1%), bacterial infections (n=33/377; 8.8%)], pruritus (n=47/377; 12.5%), xerosis (n=39/377; 10.3%), diabetic dermopathy (n=36/377; 9.5%) and diabetic ulcers (n=24/377; 6.4%). Uncommon manifestations were necrobiosis lipoidica diabeticorum, alopecia areata, scleredema diabeticorum and granuloma annulare. Cutaneous reactions due to treatment of diabetes were noted in 4 (1%) patients.</p><p class="abstract"><strong>Conclusions:</strong> As prevalence of cutaneous manifestations is high in diabetic patients, knowledge of these will help in a timely and comprehensive management of both diabetes and dermatoses.</p>

scholarly journals Crude extract and isolated bioactive compounds from Notholirion thomsonianum (Royale) Stapf as multitargets antidiabetic agents: in-vitro and molecular docking approaches

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mater H. Mahnashi ◽  
Yahya S. Alqahtani ◽  
Ali O. Alqarni ◽  
Bandar A. Alyami ◽  
Muhammad Saeed Jan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Molecular Docking ◽  
Research Work ◽  
Docking Studies ◽  
Common Disease ◽  
World Population ◽  
Binding Interactions ◽  
Molecular Docking Studies ◽  
Crude Extracts

Abstract Background Diabetes mellitus is a common disease effecting the lifestyles of majority world population. In this research work, we have embarked the potential role of crude extracts and isolated compounds of Notholirion thomsonianum for the management diabetes mellitus. Methods The crude extracts of N. thomsonianum were initially evaluated for α-glucosidase, α-amylase and antioxidant activities. The compounds were isolated from the activity based potent solvent fraction. The structures of isolated compounds were confirmed with NMR and MS analyses. The isolated compounds were tested for α-glucosidase, α-amylase, protein tyrosine phosphatase 1B (PTP1B) and DPPH activities. The molecular docking studies were carried out to find the binding interactions of isolated compounds for α-glucosidase, α-amylase and PTP1B. Results Initially, we screened out crude extracts and subfractions of N. thomsonianum against different in-vitro targets. Among all, Nt.EtAc was observed a potent fraction among all giving IC50 values of 67, 70, < 0.1, 89 and 16 μg/mL against α-glucosidase, α-amylase, DPPH, ABTS and H2O2 respectively. Three compounds (Nt01, Nt02 and Nt03) were isolated from Nt.EtAc of N. thomsonianum. The isolated compounds Nt01, Nt02 and Nt03 exhibited IC50 values of 58.93, 114.93 and 19.54 μM against α-glucosidase, while 56.25, 96.54 and 24.39 μM against α-amylase respectively. Comparatively, the standard acarbose observed IC50 values were 10.60 and 12.71 μM against α-glucosidase, α-amylase respectively. In PTP1B assay, the compounds Nt01, Nt02 and Nt03 demonstrated IC50 values of 12.96, 36.22 and 3.57 μM in comparison to the standard ursolic acid (IC50 of 3.63 μM). The isolated compounds also gave overwhelming results in DPPH assay. Molecular docking based binding interactions for α-glucosidase, α-amylase and PTP1B were also encouraging. Conclusions In the light of current results, it is obvious that N. thomsonianum is potential medicinal plant for the treatment of hyperglycemia. Overall, Nt.EtAc was dominant fraction in all in-vitro activities. Three compounds Nt01, Nt02 and Nt03 were isolated from ethyl acetate fraction. The Nt03 specifically was most potent in all in-vitro assays. The molecular docking studies supported our in-vitro results. It is concluded that N. thomsonianum is a rich source of bioactive antidiabetic compounds which can be further extended to in-vivo based experiments.

scholarly journals Cardioprotective mechanism of SGLT2 inhibitor against myocardial infarction is through reduction of autosis

2021 ◽  
Author(s):  
Kai Jiang ◽  
Yue Xu ◽  
Dandan Wang ◽  
Feng Chen ◽  
Zizhuo Tu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Ventricular Remodeling ◽  
Sglt2 Inhibitor ◽  
Glucose Deprivation ◽  
Protective Mechanism ◽  
Diabetic Patients ◽  
Autophagic Flux ◽  
Cardioprotective Effects

AbstractSodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular mortality in patients with diabetes mellitus but the protective mechanism remains elusive. Here we demonstrated that the SGLT2 inhibitor, Empagliflozin (EMPA), suppresses cardiomyocytes autosis (autophagic cell death) to confer cardioprotective effects. Using myocardial infarction (MI) mouse models with and without diabetes mellitus, EMPA treatment significantly reduced infarct size, and myocardial fibrosis, thereby leading to improved cardiac function and survival. In the context of ischemia and nutritional glucose deprivation where autosis is already highly stimulated, EMPA directly inhibits the activity of the Na+/H+ exchanger 1 (NHE1) in the cardiomyocytes to regulate excessive autophagy. Knockdown of NHE1 significantly rescued glucose deprivation-induced autosis. In contrast, overexpression of NHE1 aggravated the cardiomyocytes death in response to starvation, which was effectively rescued by EMPA treatment. Furthermore, in vitro and in vivo analysis of NHE1 and Beclin 1 knockout mice validated that EMPA’s cardioprotective effects are at least in part through downregulation of autophagic flux. These findings provide new insights for drug development, specifically targeting NHE1 and autosis for ventricular remodeling and heart failure after MI in both diabetic and non-diabetic patients.

scholarly journals PATTERN OF CUTANEOUS MANIFESTATIONS OF DIABETES MELLITUS

2020 ◽  
pp. 1-3
Author(s):  
Satpal Yadav ◽  
Aman Goyal ◽  
Poonam Verma
Keyword(s):  
Diabetes Mellitus ◽  
Acanthosis Nigricans ◽  
Cutaneous Manifestation ◽  
Skin Disorders ◽  
Cutaneous Manifestations ◽  
Cutaneous Infections ◽  
Endocrine Disorder ◽  
Study Results ◽  
Common Skin ◽  
The Common

BACKGROUND: Diabetes is most common endocrine disorder with increasing prevalence worldwide. Every organs system is affected by it albeit at different pace. This study was carried out with the aim of studying cutaneous manifestation of diabetes mellitus. METHODS- 200 cases of diabetes mellitus with cutaneous manifestations attending out patient department of dermatology were included in the study. RESULTS - The common skin disorders were cutaneous infections (53.5%), acanthosis nigricans (10.5%), generalized pruritus (10.5%),skintags (9.5%). CONCLUSION - most common dermatological manifestations were cutaneous infections.

scholarly journals COMPARISON OF ANTIFUNGAL EFFECTS OF COMMERCIALLY AVAILABLE HERBAL MOUTHWASHES AND CHLORHEXIDINE AGAINST CANDIDA ALBICANS IN DIABETIC PATIENTS: AN IN VITRO STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 214
Author(s):  
Chandini Ravikumar ◽  
Radhika Arjunkumar ◽  
Gopinath Prakasam
Keyword(s):  
Diabetes Mellitus ◽  
Candida Albicans ◽  
Periodontal Diseases ◽  
In Vitro Study ◽  
Average Diameter ◽  
Diabetic Patients ◽  
Zone Of Inhibition ◽  
Zones Of Inhibition ◽  
Vitro Effect

ABSTRACTObjective: Candida albicans is a part of the normal flora of the mouth in diabetes mellitus (DM) patients. Periodontitis is one of the main complicationsin diabetic patients. Mechanical and chemical plaque control are the most productive methods in preventing periodontal diseases in the oral cavity.The objective of this study is to compare the in vitro effect of herbal mouthwashes and chlorhexidine (CHX) against C. albicans.Methods: Saliva samples were obtained from diabetic patients reporting for treatment to Saveetha medical college. C. albicans was cultured from thesalivary sample. A yeast suspension was made by sub culturing the C. albicans. The mouthwashes used in the study are HiOra regular (0.2%), HiOrasensitive (0.5%), and clohex plus (CHX gluconate 0.02%) mouthwashes. The fungal suspension was spread on Sabouraud’s dextrose agar (SDA) plateswith a sterile swab. Subsequently, wells of 6 mm in diameter were made with a suitable distance using sterile cork borer on pre-inoculated agar platesand filled with 100 µl of each mouthwashes. From the zones of inhibition seen, antimicrobial activity was expressed in terms of average diameter ofthe zones of inhibition measured.Results: Using HiOra regular mouthwash, 13/18 (72%) wells were found to show zone of inhibition ≥20 mm. In HiOra sensitive mouthwash, only9/18 (50%) showed inhibition zone ≥20 mm. With effect of regular CHX mouthwash, none of the strains showed the zone of inhibition to be ≥20 mm.Most of the strains responded well with all the three mouthwashes.Conclusion: Among the 2 herbal mouthwashes, HiOra regular mouthwash was most effective in inhibiting the candidal growth when compared tothe HiOra sensitive. HiOra regular mouthwash still showed better inhibitory actions when compared to the regular CHX mouthwash and the candidalspecies showed increased sensitivity to it.Keywords: Candida albicans, Chlorhexidine mouthwash, Diabetes mellitus, Herbal mouthwashes, Zone of inhibition.

scholarly journals The burden of Diabetes, Its Oral Complications and Their Prevention and Management

2018 ◽  
Vol 6 (8) ◽  
pp. 1545-1553 ◽  
Author(s):  
Muhammad Ashraf Nazir ◽  
Lamiah AlGhamdi ◽  
Mariam AlKadi ◽  
Noura AlBeajan ◽  
Latifah AlRashoudi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Oral Health ◽  
Periodontal Disease ◽  
International Diabetes Federation ◽  
World Health ◽  
Diabetic Patients ◽  
High Blood Glucose ◽  
Systemic Complications ◽  
Oral Complications

BACKGROUND: Diabetes mellitus (DM), chronic disease, is a public health problem that affects 8.5% adult population worldwide. The number of adults with DM has risen sharply from 108 million in 1980 to 422 million in 2014. In 2012, 1.5 million individuals died because of DM and an additional 2.2 million deaths occurred because of high blood glucose level resulting in cardiovascular and other systemic diseases. DM brings huge economic loss to patients, their families, and healthcare systems. Globally, the cost of DM was US$1•31 trillion in 2015.AIM: This review article utilised the prevalence data of diabetes mellitus from the World Health Organization and International Diabetes Federation to provide a comprehensive picture of the disease in different parts of the world.METHODS: Electronic databases such as Google Scholar, Medline via PubMed, Scopus, and Web of Science were used to search the literature. The library resources of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia were used to retrieve studies on the topics of the present review.RESULTS: Systemic complications of DM include heart attack, kidney disease, limb loss, blindness, and peripheral nerve damage. More than 90% of diabetic patients were found to have oral manifestations. It is known that DM severely damages oral tissues causing periodontal disease, tooth loss, xerostomia, caries, burning mouth disorder, taste and salivary gland dysfunction, delayed wound healing, lichen planus, geographic tongue, and candidiasis. The evidence is mounting about a strong bidirectional relationship between DM and periodontal disease. Unfortunately, many diabetic patients are unaware of the association between DM and oral health, and only a small percentage of them visit the dentist for routine dental check-ups. Changes in lifestyles (control of blood glucose levels and self-care practices), regular dental check-ups with emphasis on periodontal assessment, and reinforcement of oral health instructions can effectively prevent oral complications of DM. Scaling and root planning are effective in improving glycemic control among diabetic patients.CONCLUSION: Dental professionals should be part of the multidisciplinary team that helps individuals with diabetes.

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