Diabetes, Glycation, Skincare, Glycemic Index, and Diabetes Management
Diabetes is a metabolic disorder that is characterized by improper food processing due to irregular insulin levels. Type 2 diabetes mellitus is an improper use of insulin by the body, which is due to lifestyle and is diagnosed later on in life. Type 1 diabetes is a genetic disorder diagnosed predominantly in children, where the body produces antibodies against beta- pancreatic cells, and thus the pancreas cannot produce insulin (Diabetes care).
Patients who have diabetes are more sensitive to foods with a high glycemic index, which increase their blood glucose levels and cause hyperglycemia. The high blood glucose levels react with proteins in the body and produce advanced glycation end products (AGEs. Collagen is a highly sensitive protein, present predominantly in the face, and is targeted by AGEs and accelerates aging, especially in the presence of UV light. This leads to premature signs of aging, sagging, and loss of radiance (Danby, F., Gkogkolou, P.).
Prevention and management include lifestyle management with diet and exercise. Patients with diabetes should eat foods that have a low glycemic index and are high in fiber, fruits and vegetables, proteins, and healthy fats. American Diabetes Association (ADA) recommends that diabetics should do moderate- intensity exercise at least 5 times a week for 30 minutes. Lifestyle management is crucial to managing weight, controlling blood sugar levels, and increasing insulin sensitivity. Additionally, pharmacological management is integral to properly managing blood glucose levels. There are multiple classes of antidiabetic agents and pharmacological regimens are individualized to a patient’s specific management goals (David P).
Chronic hyperglycemia due to improperly managed diabetes can cause microvascular damage and neuropathy. The microvascular damage leads to decreased circulation and thus dry skin. Patients should be counseled to moisturize their skin, especially their hands and feet, with a gentle moisturizer that is fragrance- free. Neuropathy can lead to peripheral nerve damage, which can lead to diabetic foot infections (DFIs). DFIs happen when a patient is not aware of a wound, and the infection can grow, and in severe infections can spread to the bone. Patients should be counseled on proper foot care, which includes properly washing the feet daily and taking time to inspect the soles of the feet, get regular pedicures, and wear comfortable shoes when walking or exercising (David P, Dryden, M).
David P, Singh S, Ankar R. A Comprehensive Overview of Skin Complications in Diabetes and Their Prevention.Cureus. 2023;15(5):e38961. Published 2023 May 13. doi:10.7759/cureus.38961
Dryden M, Baguneid M, Eckmann C, et al. Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: Focus on skin and soft-tissue infections. Clinical Microbiology and Infection. 2015;21. doi:10.1016/j.cmi.2015.03.024
Gkogkolou, P., & Böhm, M. (2012). Advanced glycation end products: Key players in skin aging?.Dermato-endocrinology, 4(3), 259–270. https://doi.org/10.4161/derm.22028
Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord. 2013;12(1):14. Published 2013 Mar 5. doi:10.1186/2251-6581-12-14
Diabetes, Glycation, Skincare, Glycemic Index, and Diabetes Management
Diabetes is a metabolic disorder that is characterized by improper food processing due to irregular insulin levels. Type 2 diabetes mellitus is an improper use of insulin by the body, which is due to lifestyle and is diagnosed later on in life. Type 1 diabetes is a genetic disorder diagnosed predominantly in children, where the body produces antibodies against beta- pancreatic cells, and thus the pancreas cannot produce insulin (Diabetes care).
Patients who have diabetes are more sensitive to foods with a high glycemic index, which increase their blood glucose levels and cause hyperglycemia. The high blood glucose levels react with proteins in the body and produce advanced glycation end products (AGEs. Collagen is a highly sensitive protein, present predominantly in the face, and is targeted by AGEs and accelerates aging, especially in the presence of UV light. This leads to premature signs of aging, sagging, and loss of radiance (Danby, F., Gkogkolou, P.).
Prevention and management include lifestyle management with diet and exercise. Patients with diabetes should eat foods that have a low glycemic index and are high in fiber, fruits and vegetables, proteins, and healthy fats. American Diabetes Association (ADA) recommends that diabetics should do moderate- intensity exercise at least 5 times a week for 30 minutes. Lifestyle management is crucial to managing weight, controlling blood sugar levels, and increasing insulin sensitivity. Additionally, pharmacological management is integral to properly managing blood glucose levels. There are multiple classes of antidiabetic agents and pharmacological regimens are individualized to a patient’s specific management goals (David P).
Chronic hyperglycemia due to improperly managed diabetes can cause microvascular damage and neuropathy. The microvascular damage leads to decreased circulation and thus dry skin. Patients should be counseled to moisturize their skin, especially their hands and feet, with a gentle moisturizer that is fragrance- free. Neuropathy can lead to peripheral nerve damage, which can lead to diabetic foot infections (DFIs). DFIs happen when a patient is not aware of a wound, and the infection can grow, and in severe infections can spread to the bone. Patients should be counseled on proper foot care, which includes properly washing the feet daily and taking time to inspect the soles of the feet, get regular pedicures, and wear comfortable shoes when walking or exercising (David P, Dryden, M).
Citations:
Danby F. W. (2010). Nutrition and aging skin: sugar and glycation. Clinics in dermatology, 28(4), 409–411. https://doi.org/10.1016/j.clindermatol.2010.03.018
David P, Singh S, Ankar R. A Comprehensive Overview of Skin Complications in Diabetes and Their Prevention. Cureus. 2023;15(5):e38961. Published 2023 May 13. doi:10.7759/cureus.38961
Diabetes care. American Diabetes Association. https://diabetesjournals.org/care/issue/44/Supplement_1. Published January 1, 2021. Accessed March 10, 2022.
“Dermatologist-Recommended Skin Care for People with Diabetes.” American Academy of Dermatology, https://www.aad.org/public/diseases/a-z/diabetes-skin-care.
Dryden M, Baguneid M, Eckmann C, et al. Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: Focus on skin and soft-tissue infections. Clinical Microbiology and Infection. 2015;21. doi:10.1016/j.cmi.2015.03.024
Gkogkolou, P., & Böhm, M. (2012). Advanced glycation end products: Key players in skin aging?. Dermato-endocrinology, 4(3), 259–270. https://doi.org/10.4161/derm.22028
Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord. 2013;12(1):14. Published 2013 Mar 5. doi:10.1186/2251-6581-12-14