Some of the most common questions in any diabetic clinic relate to skin lesions and whether they relate to diabetes or not. Many do not but particular care is needed not to miss skin lesions that may need referral to a dermatologist such as an early skin cancer.

Skin infections, especially those caused by fungal infiltration of the skin are more common in people whose blood glucose levels are high. These may present on the feet but are also quite common all over the body and especially in the skin creases and folds. There are usually relatively simple treatments for these complaints. Problems often arise in the diagnosis of the complaint and whether there are co-existent skin disorders such as eczema or psoriasis.

Bacterial infections are also more common when diabetes is poorly controlled and these may present as boils or carbuncles. They will need to be treated promptly with antibiotics and often a referral to a general surgeon so that drainage of the abscess can be carried out.

Joint and bone complaints are common in diabetes patients especially when the blood glucose control has been poor. Common complaints include pains in the joints such as those in the hands. These may relate to a range of causes including median nerve compression, known as carpel tunnel syndrome, and stiffness of the joints relating to the direct action of high glucose on the normal functioning of joints and tendons. A frozen shoulder is another common example of this problem. Many of our patients also need to be reviewed by a specialist in Rheumatology or Orthopaedics because of the frequent and specific nature of these complications.

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