The CGM Blog
The Connection Between Blood Sugar and Skin Health
Our skin is our largest organ. Because the skin plays such an essential role in the body, many different aspects of our health have an impact on it. Diabetes and changes in blood sugar levels can influence how skin functions. This means that individuals living with diabetes are more likely to experience certain skin conditions. 1,2
It’s important to understand how blood sugar impacts your skin and how to care for it to support your overall well-being as part of your diabetes self-management routine. Most of us will experience some kind of skin condition throughout our lives. If you’re experiencing skin changes due to diabetes, know that there are plenty of treatment options to help you feel good inside and out.
How Blood Sugar Levels Impact Your Skin
Individuals living with diabetes are more likely to experience certain skin conditions because they are at greater risk of having high blood sugar levels.2 High blood sugar, or hyperglycemia, can affect the network of nerves, blood vessels, and cells that make up our skin. When there is excess sugar, or glucose, in the blood, the body pulls fluid from cells in the skin and other organs to make more urine and eliminate it.2 Having high glucose levels over a long period of time can damage blood vessels and lead to poor circulation. These factors make it more likely that individuals living with diabetes will experience very dry, itchy skin that’s vulnerable to infection.2
Poor circulation and nerve damage also make it harder for the body to heal wounds effectively. Wounds that don’t heal fast enough are more prone to infection. High glucose levels increase the risk of a fungal or bacterial infection as microscopic fungi and bacteria feed on sugar.2,4
The relationship between diabetes and the skin is very complex. Some skin conditions are caused or worsened by hyperglycemia, but others are affected by different factors that are not within your control—such as skin conditions caused by genetics. Other skin conditions associated with diabetes do not have a clear cause at all.2,5,6
Common Skin Conditions Associated with Diabetes
There are a few skin conditions that only occur in those living with diabetes. There are also some common skin conditions anyone can get but individuals living with diabetes are more likely to experience. Here are just a handful of skin conditions that are associated with diabetes.
Eczema
Eczema often appears as extremely dry, cracked skin that oozes and can lead to swelling or thickening of the area. This condition is caused by genetics or an overgrowth of certain types of bacteria on the skin.5 Individuals living with diabetes are at higher risk of bacterial infections that can promote eczema.2,5 High glucose levels can also dry skin out, which increases the chance of developing eczema.2,5 Washing your hands frequently or using harsh soaps and chemicals on bare skin can also trigger an eczema rash. Eczema can be treated with medicated creams, light therapy, and injections of medicine.5
Psoriasis
There are several different types of psoriasis. The most common form is plaque psoriasis which looks like thick, scaly patches that have a silvery or grey colour.6 These patches can develop anywhere on the skin but typically occur on the scalp, elbows, knees, and lower back. Psoriasis and diabetes are closely linked. Studies show that psoriasis and diabetes may be influenced by the same genes and autoimmune responses in the body. 7 Individuals living with psoriasis are more likely to develop diabetes and diabetes is a risk factor for developing psoriasis. Psoriasis is treated with medicated creams, oral medicines or injections, and light therapy.6
Shin Spots
This condition is also known as diabetic dermopathy. It appears as harmless red or brown spots on the front of your legs and shins. They look a bit like age spots and they shouldn’t hurt or itch. Shin spots happen because of minor changes in the blood vessels.2 You don’t need to treat shin spots, but be sure to talk to your doctor if you notice pain or irritation.2
Necrobiosis Lipoidica
Similar to shin spots, necrobiosis lipoidica appears as dark spots on the lower legs which may be caused by changes in blood vessels. However, this skin condition develops into a patch that looks like a shiny, raised scar with a purple outline. Sometimes, the patch is itchy and painful and may crack open. Women are more likely to have necrobiosis lipoidica, but it is a fairly rare condition.1,2
Acanthosis Nigricans
Acanthosis nigricans (AN) appears as a dark, velvety patch of skin in a place where there’s a fold, such as the armpits, neck, or groin. This skin condition can be an early sign of insulin resistance, which is where the body isn’t effectively using insulin to absorb glucose for energy.2 Individuals living with obesity are more likely to experience AN. There are creams that can improve the look of AN, but lifestyle changes to address obesity and insulin resistance are the most effective treatments.2
Infections
Bacterial and fungal infections can happen to anyone, but individuals experiencing high blood sugar are at higher risk as bacteria and fungi thrive on sugar.2 Bacterial infections cause the skin to become red and swollen. Common bacterial infections include styes on the eyelids and boils that develop deep under the skin.8 Antibiotics are typically required for treatment. Fungal infections look like a scaly rash with blisters and can be very itchy. Specific antifungal medications can treat these infections.8
Support Healthy Skin with Diabetes Self-Care
Many skin conditions associated with diabetes are potentially preventable with daily self-care routines and glucose management. Be sure to discuss how caring for your skin fits into your diabetes management plan with your doctor and diabetes care team. There are a few things you can do to support your skin that can also have a positive impact on your overall well-being.
1. Prioritize Skin Care
Taking care of your skin on a daily basis is an integral part of your overall diabetes management. Here are just a few tips you may want to incorporate into your diabetes skincare routine:1
- Keep your skin clean and moisturized every day.
- Avoid hot showers and baths which can dry skin out and may lead to cracking.
- Dry your feet thoroughly after you bathe, and don’t put moisturizer between your toes as it may promote fungal infection.
- Remember to moisturize exposed skin, especially in cold or dry weather.
- Use a humidifier during dry months.
2. Address Cuts and Blisters Immediately
Diabetes can make it more difficult for the body to heal wounds.1,2 It’s important to be mindful of minor cuts or scrapes and treat them right away. Wash wounds with soap and warm water.1 Make sure you consult with your doctor before using antibiotic or steroid creams to treat wounds.
Some individuals living with diabetes experience foot neuropathy, which is when the nerves in the feet become damaged. If you experience neuropathy, you may not always feel blisters or cuts on your feet and lower legs. Diabetes Canada recommends that individuals living with diabetes should practice foot care, which can include:9
- Examining your feet and legs for blisters and scrapes every few weeks.
- Caring for your toenails.
- Using moisturizer on dry areas.
- Wearing properly fitted shoes.
- Seeking treatment for corns, calluses, ingrown toenails, warts, and splinters from your doctor or medical foot care professional.
3. Manage Your Glucose Levels
Maintaining your glucose levels is an important part of managing diabetes. Working to spend more time in your target glucose range may help you get out ahead of skin conditions caused by high blood sugar.1,8 Diabetes Canada generally recommends that individuals aim to keep their glucose levels between 3.9 and 10.0 mmol/L but you should determine your personalized target range with your doctor.
Your doctor can help you determine the best ways to help you manage your glucose levels. This can include lifestyle changes such as diet and exercise as well as medication for glucose control or insulin injections. One of the ways to get a better idea of what affects your glucose levels every day, and over time, is to use a continuous glucose monitoring (CGM) system. Keeping track of your glucose levels using a CGM system has been shown to increase time spent in your target range and decrease A1C.
Transform the Way You Manage Your Glucose
The Dexcom G7 CGM System can make it easier to stay on top of your glucose levels throughout the day. It can provide continuous glucose readings directly to a compatible smart device or receiver, without the need for routine fingersticks.*† With our smallest sensor yet, Dexcom G7 gives you the freedom to look after your glucose levels with greater confidence.
* For a list of compatible devices, please visit www.dexcom.com/compatibility.
† Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
† Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
- Diabetes and Skin Complications. American Diabetes Association. Accessed October 10, 2023. https://diabetes.org/about-diabetes/complications/skin-complications
- Diabetes and Your Skin. Centers for Disease Control and Prevention. Reviewed June 14, 2022. Accessed October 10, 2023. https://www.cdc.gov/diabetes/library/features/diabetes-and-your-skin.html
- Poor Blood Circulation. Diabetes.co.uk. January 15 2019. Reviewed January 25, 2023. Accessed October 10, 2023. https://www.diabetes.co.uk/diabetes-complications/poor-blood-circulation.html
- Slow Healing of Cuts and Wounds. Diabetes.co.uk. January 15 2019. Reviewed January 25, 2023. Accessed October 10, 2023. https://www.diabetes.co.uk/symptoms/slow-healing-of-wounds.html
- Atopic dermatitis (eczema). Mayo Clinic. May 9, 2023. Accessed October 10, 2023. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
- Psoriasis. Mayo Clinic. October 8, 2022. Accessed October 10, 2023. https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840
- Abramczyk R, et al. Diabetes and Psoriasis: Different Sides of the Same Prism. Diabetes Metab Syndr Obes. 2020;13:3571-3577. doi: 10.2147/DMSO.S273147
- Diabetes Rash and Other Skin Conditions. Cleveland Clinic. Reviewed August 21, 2021. Accessed October 10, 2023. https://my.clevelandclinic.org/health/articles/12176-diabetes-skin-conditions
- Embil JM, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Foot Care. Can J Diabetes. 2018;42 Suppl 1:S222-S227. doi:10.1016/j.jcjd.2017.10.020
- Imran AS, et. al. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Targets for Glycemic Control. Can J Diabetes 2018:42(S42–S46). doi: 10.1016/j.jcjd.2017.10.030
- Welsh JB, et al. J Diabetes Sci Technol. 2022:19322968221099879.
- *Diabetes outcomes refers to clinical outcomes such as improved time in range and reduction of A1C