Millions of people in the UK suffer from a potentially deadly condition – but hundreds of thousands more do not realise they have it. Latest figures from Diabetes UK show more than 4.4 million people in the UK live with diabetes.
However there are believed to be an additional 1.2 million possibly undiagnosed cases of type 2 diabetes (T2D) with an estimated 3.2 million people at increased risk of developing the condition based on their blood sugar levels.
Failure to diagnose and treat diabetes can be deadly. It has been previously highlighted by the charity that: “Without the right care and support, people with all types of diabetes can be at risk of developing serious complications. Every week, diabetes leads to 184 amputations, more than 930 strokes, 660 heart attacks and 2,990 cases of heart failure.”
So it is vital to be aware of any potential signs that you might have the condition – and some are better known than others. Many people know that going to the toilet more often or feeling constantly thirty can be signs but according to experts there are 10 lesser-known signs that appear in the skin.
The American Academy of Dermatology warns diabetes can affect many parts of your body, including your skin. When diabetes affects the skin, it could mean that:
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You have undiagnosed diabetes or pre-diabetes.
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Your treatment for diabetes needs to be adjusted.
And the skin specialists say it’s time to talk with your doctor if you notice any of these warning signs on your skin.
Shin spots
This is common in people with diabetes. The medical name for shin spots is diabetic dermopathy but is sometimes referred to as spotted leg syndrome.
The condition usually starts with round or oval spots, which often develop on the shins. The spots may be brown or reddish brown in colour. Early on, these spots often feel scaly. As they flatten out, they can cause small dents in the skin.
Because these spots are often brown and cause no symptoms like itch or pain, many people mistake them for age spots. Unlike age spots, these spots often start to fade after diabetes is well-controlled, usually within 18 to 24 months. However they can remain indefinitely.
The AAD warns: “While these spots are harmless, anyone who develops them and hasn’t been diagnosed with diabetes should be tested. If you have diabetes, tell your doctor about these spots.
“Some people who have diabetes and shin spots have a higher risk of developing complications from diabetes like neuropathy, which is nerve damage that can lead to weakness, numbness, and pain.”
Darker area of skin that feels like velvet
A dark patch (or band) of velvety skin on your neck, armpit, groin, or elsewhere could be a sign of pre-diabetes, says the AAD. “The medical name for the condition that causes this velvety skin is acanthosis nigricans. Often developing on the back of the neck, this condition may be the first sign that someone has diabetes or prediabetes.”
Hard, thickening skin
Diabetes can lead to hard, thick, and swollen-looking skin developing – called scleredema diabeticorum – even when the condition is well controlled. The AAD says: “Often developing on the upper back, the skin thickens and tightens slowly over months or years. This condition can also occur on the shoulders, neck, or elsewhere, but never on the hands or feet.
“Some people have discolouration where the skin is hard and thickening. While the skin hardens and thickens, the condition is painless.”
Open sores and wounds
Having high blood sugar (glucose) for a long time can lead to poor circulation and nerve damage, warns the specialists. They say: “You may have developed these if you’ve had uncontrolled (or poorly controlled) diabetes for a long time.
“Poor circulation and nerve damage can make it hard for your body to heal wounds. This is especially true on the feet. The open wounds are called diabetic ulcers.
“If you have diabetes, check your feet every day for sores and open wounds If you see a sore, cut, open wound, swelling, discolouration, or other change, contact your doctor right away.”
Outbreak of small bumps
If diabetes is uncontrolled it can cause extremely high levels of triglycerides, a type of fat that circulates in the blood. If this happens, you can develop a skin condition called eruptive xanthomatosis, says the AAD. It adds: “If you have undiagnosed diabetes or diabetes that is not well controlled, these bumps can appear on your skin suddenly.
“After the bumps appear, they soon develop a yellowish colour in lighter skin tones. If you have a darker skin tone, you may see a greyish colour with a yellowish hue beneath.
“You’ll usually find these bumps on the buttocks, thighs, crooks of the elbows, or knees. They can form anywhere though. No matter where they form, they are usually tender and itchy. Once the diabetes is well-controlled, the bumps tend to go away.”
Yellowish bumps on and around your eyelids
These bumps and patches, called xanthelasma, develop when you have high levels of fat in your blood, which can be a sign that you have poorly controlled diabetes, says the AAD. It says: “Regardless of your skin tone, these bumps and patches look yellowish or yellowish orange in colour.
“The yellowish bumps and patches usually appear in about the same place on (or around) both eyelids. These bumps and patches can feel soft or somewhat hard.”
Infections
“Diabetes weakens your immune system, which reduces your body’s ability to fight off harmful germs and increases your risk of developing infections,” explains the AAD. “It’s common to develop infections in the mouth like oral thrush or in the vagina like a yeast infection. However if you get several yeast infections each year ask your doctor if you might have diabetes or pre-diabetes”.
Skin tags
Many people have skin tags – acrochordons – which are harmless growths that can appear anywhere on the skin. Sometimes, skin tags are firmly fixed to the skin. You may also see ones that dangle from a stalk.
The AAD says: “While skin tags can develop anywhere on the skin, they are most common on the eyelids, neck, armpit, and groin. While harmless, having many skin tags may be a sign that you have type 2 diabetes.”
Cluster of small bumps or a raised patch
The AAD says: “Whether this skin condition is associated with diabetes is controversial. We know that most people who have granuloma annulare do not have diabetes.
“Several studies, however, have found this skin condition in patients who have diabetes. One such study found that people with diabetes were most likely to have granuloma annulare over large areas of skin and that the bumps came and went.
“Another study concluded that people who have granuloma annulare that comes and goes should be tested for diabetes. This skin condition causes bumps and patches that may be skin coloured, red, pink, or bluish purple.”
Yellow, reddish, brown, or purplish patches on your skin
The AAD says in the early days of diabetes, sufferers can often see one or a few reddish-brown spots on your shins if you have a lighter skin tone. They say: “People with darker skin tones often see purplish spots. These spots aren’t itchy or painful. The medical name for this condition is necrobiosis lipoidica.
“These spots grow slowly, becoming one or more patches that may be yellow, reddish, brown, or purplish. In the centre, you may see waxy skin that is thinning, blood vessels, or both.
Other symptoms of diabetes
According to the NHS many people have type 2 diabetes without realising. This is because they may not always notice any symptoms.
However it advises there are some better known symptoms which need to be checked if you develop them. Symptoms of type 2 diabetes can include:
- peeing more than usual
- feeling thirsty all the time
- feeling very tired
- losing weight without trying to
- itching around your penis or vagina, or repeatedly getting thrush
- cuts or wounds taking longer to heal
- blurred vision
When to seek medical help
The NHS says you should see a GP if:
- you have any of the symptoms of type 2 diabetes
- you’re worried you may have a higher risk of getting type 2 diabetes
You will need a blood test, which you may have to go somewhere else for, such as your local health centre or hospital, if it cannot be done at your GP surgery. The earlier diabetes is diagnosed and treatment started, the better. Early treatment reduces your risk of other health problems.