How Does Diabetes Affect Psoriasis?

People who have psoriasis are more likely to get type 2 diabetes. That's a condition that makes it hard for your body to make and use the hormone insulin. And the worse your skin problem is, the greater your chances of getting diabetes are.

More research is needed to explain why this happens, but your immune system may have something to do with it. Psoriasis, which causes raised, red, flaky, and itchy patches on your skin, is an autoimmune disease. That means your immune system attacks part of your own body by mistake. In this case, it's your skin.

One theory is that psoriasis could change your immune system enough that over time, it starts going after and killing cells that make insulin.

How Diabetes Can Affect Psoriasis

It's important for the doctor you see for your psoriasis to know you have diabetes so she can recommend the right treatments.

In some cases, she may be able to give you medicine that helps keep both health issues in check. For instance, some people who take a type 2 diabetes drug called a glucagon-like peptide-1 (GLP-1) notice that their skin gets better. This may be because it slows down your immune system. That helps ease inflammation throughout your body.

On the other hand, some drugs that treat psoriasis can raise your blood sugar and make your diabetes harder to control. That means your doctor probably won't give you corticosteroids (steroids) or cyclosporine, which are both used to calm inflammation.

You'll need to use other psoriasis drugs with some care. For example, a medicine called etanercept can trigger hypoglycemia (very low blood sugar). If your doctor thinks it's the best option to treat your psoriasis, you may need to change your diabetes medication.

Another common psoriasis drug called methotrexate can cause serious liver damage in people with diabetes. If your doctor prescribes it, you'll need to have a blood test in a few months to make sure your liver's working the way it should.

What You Can Do

Some lifestyle changes can help you control both your psoriasis and diabetes.

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Reduce stress. Worry and anxiety not only cause your skin to flare, but they also can raise your blood sugar. Try deep-breathing exercises, meditation, or regular exercise to keep your stress in check.

Eat healthy. Certain foods like fruits, veggies, and whole grains can help control your diabetes and psoriasis. Others (like sugary treats and alcohol) will make them worse. Ask a dietitian or nutritionist to help you plan healthy meals.

Watch your weight. Being a healthy weight helps your body respond better to psoriasis treatments. It also makes your blood sugar levels easier to manage.

Work as a team. In addition to your primary care doctor, you'll probably see a dermatologist to care for your skin and an endocrinologist to help you control your diabetes. If you have psoriatic arthritis, you'll also see a rheumatologist. And you may want to see a counselor to talk about your feelings. Find health care providers you trust and make sure they talk to one another to give you the care you need.

Ask questions. Learn about the drugs you take, their side effects, and how long you'll need to be on them. If you don't understand something or have concerns about anything, ask your doctor.

WebMD Medical Reference Reviewed by Debra Jaliman, MD on 2/, 017

Sources

SOURCES:

Delphine J. Lee, MD, PHD, FAAD, chief and residency program director, division of dermatology, department of medicine, Harbor-UCLA Medical Center, Torrance, CA; principal investigator, Los Angeles Biomedical Research Institute, Torrance CA;  director, Dermatological Center for Skin Health at Providence SJHC, Santa Monica, CA.

Global Dermatology: "Systemic therapy of psoriasis in diabetic patients."

Journal of the American Academy of Dermatology: "Persistent hypoglycemia in a patient with diabetes taking etanercept for the treatment of psoriasis."

UC Davis Health: "People with severe psoriasis have nearly twice the risk of diabetes."

UpToDate: "Treatment of psoriasis."

National Psoriasis Foundation: "Type 2 diabetes drug helps psoriasis, too," "Six diet tips to help with psoriasis, psoriatic arthritis," "How to build your own health care team," "Stress and psoriatic disease."

American Diabetes Association: "Weight Loss," "Skin Care," "Foot Care," "Stress."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers about Psoriasis."

UW Health: "A Sweet Alternative: Topical Honey Shows Promise in Healing Diabetic Ulcers."

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