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Diabetes and Skin Infections

Bacterial skin infections are pretty common with diabetes, says Betul Hatipoglu, MD, of the Endocrinology and Metabolic Institute at Cleveland Clinic in Ohio. "It can be as simple as a boil in the armpit or on the face, infection of the hair follicles, or infection of the nail bed," she says. Almost a third of people with diabetes will get a skin infection at some time in their life, Hatipoglu says.

Fungal infections are pretty common too, she says. You are most likely to have them in areas that get hot and sweaty, including:

  • Under the breasts
  • Between fingers and toes
  • In the armpits
  • In the groin area
  • Around the tip of the penis, if you are an uncircumcised man

Athlete's foot, jock itch, and vaginal infections are very common in people without diabetes as well as people with it. But they can be harder to treat if you have diabetes.

So what's the best way to fight infection? "You have to make sure your blood sugars are within a normal range as much as possible," Hatipoglu says. "Bacteria and fungi like sugar, and they will multiply like crazy if you don't."

She suggests these tips to prevent and calm skin infections:

  • Check your feet and any areas of your body that get damp and sweaty every day.
  • Use moisturizer on dry skin daily to keep it from cracking and itching. Don't apply moisturizer between your toes, though.
  • If you think you have an infection anywhere on your body, call your doctor.
  • Don't try to treat skin infections at home with over-the-counter products, because they may not be strong enough.

Diabetes and Shot-Related Skin Problems

If you use insulin, you can have problems on your skin where you give yourself shots. Hudson says that two of the problems, hypertrophy and atrophy, were more common in the past, but they still happen.

  • Hypertrophy. If you keep doing your insulin shots in the same exact spot, a little mound of fat tissue can build up. It can be unsightly and keep your body from absorbing insulin as well.
  • Atrophy. With this less-common condition, Hudson says, "you actually lose the fatty tissue underneath an area of injection. So it's like a dimple." The way your body absorbs insulin may become erratic, making it hard to control your blood sugar levels.

Some people who use insulin pumps have an allergic reaction to the adhesive used to secure it to the skin. Others are allergic to some types of insulin. Reactions can range from swelling and itching to life-threatening symptoms. Your doctor can advise you on other options for either of these issues.

Prevent Skin Problems From Insulin Shots

The key to keep insulin shots from causing skin problems is to rotate the place where you give them, Hudson and Hatipoglu say. If you use a syringe or pen, pick a new spot an inch or so away from the last one each time. If you use an insulin pump, rotate spots every 2 to 3 days. To prevent infection, wash your hands and the skin area first.

Kindelan, the retired nurse who's been injecting insulin for most of her adult life, says it has helped her avoid skin problems. "I've never had them," she says. Though she has a bit of scarring, Kindelan says, "you just don't use those sites if that happens. I take four injections a day, so I rotate sites."

Hatipoglu and Hudson also advise injecting insulin in different parts of the body. How fast your body will absorb it depends on the area you use -- such as the stomach, hips, thighs, arms, or buttocks.

"In the summer, I tend not to use my legs," Kindelan says. "I think everybody feels kind of weird about using their stomach, and I avoided it for a while. Then it just seemed like too much prime territory, and it wasn't going to show. It's decidedly the most painless of all areas."