Medically reviewed by Anna Goldman, MD.
You probably already know that diabetes can affect nearly every organ throughout your body — including your eyes, kidneys, and heart. Did you know your skin is an organ, too?
In life with diabetes, your skin can endure a lot — injections, finger pokes, pump sites, and CGM sensors. Your skin is constantly working to heal, and it never gets a break.
Researchers estimate that 79 percent of people with type 1 and type 2 diabetes have skin issues, ranging from everyday skin damage (the life of a human pincushion) to diagnosable conditions that call for specialty care.
Diabetes-related skin concerns include:
- Lipohypertrophy: This is the build-up of hard fatty tissue at injection or pump sites. It’s the result of many years of taking insulin.
- Scar tissue, bruising, irritation: Another result of many years of insulin injections or managing pump and CGM sensor sites.
- Bacterial infections: These can develop anywhere, including in your eyelids, fingernails, and feet, and are more common in people with diabetes — including infections to antiresistant organisms!
- Fungal infections: Yeast-like fungi are fed by excess glucose in your urine, sweat, and bloodstream. Common infections include yeast infections, jock itch, and athlete’s foot.
- Itchy skin: Decreased circulation can lead to super-dry skin, which leaves you extra itchy.
- Acanthosis nigricans: This visible skin condition is a common sign of insulin resistance. It involves darkened patches of skin, often on the neck, groin, and armpits.
- Diabetic blisters or ulcers: A simple cut or blister can become infected and threaten the well-being of your entire foot. Don’t ignore slow-healing wounds!
- Digital sclerosis: This is the tightening and hardening of the skin on your fingers.
The data shows that even people with tightly managed blood glucose levels can experience diabetes-related skin concerns — like extra itchy or dry skin. This means everyone with diabetes should take their skin health seriously.
Tips: Prevent and Manage Diabetes Skin Issues
Here are a few things to consider as you work to manage your skin health with any type of diabetes.
Tackle Those High Blood Glucose Levels
This is step one. If you’re struggling to get your blood glucose levels into your target range, it’s worth scheduling an extra appointment with your healthcare team or a diabetes coach to tackle this ASAP.
Persistently high blood glucose levels can:
- Damage blood vessels throughout your body
- Increase overall inflammation
- Decrease circulation of healthy blood and oxygen
- Trigger infections in slow-healing wounds, blisters, cuts
- Prevent healing through decreased blood flow
- Lead to dehydration
There are many ways to help get your blood sugar back on track. It may come down to a combination of starting/adjusting your insulin doses, starting/adjusting other medications like GLP-1s or SGLT-2s, and making simple changes in your lifestyle habits. Simply swapping soda for flavored seltzer or walking every day after dinner can have a huge impact. The more you can get those numbers down, the more you might feel a boost in your mood and energy, too. It’s worth it.
Establish a Helpful Skin Routine
Back to all those punctures and old CGM or pump sites: There are a few steps you can take to prevent infections, relieve irritated skin, and encourage healing.
- Alcohol swabs: It’s easy to forget how much bacteria lives on your skin. Before and after managing any new sensor or cannulas, you should thoroughly clean the area with an alcohol swab. It’s worth swabbing a broader area than the site itself. The goal is to eliminate any bacteria that could irritate or develop into an infection around your CGM or pump site. This step is a must! Don’t skip this.
- Healing lotions: Many lotion products contain ingredients that might irritate your skin or even contain steroids, but some manufacturers have created products specifically for people with diabetes. You can find lotions, gels, and creams that are designed for everyday use or for wound care, offering both pain relief and protection against infections.
- Rotate your injection/CGM/pump sites: Don’t beat up your skin more than you have to! Establishing a consistent site rotation routine can prevent overusing one area. We all tend to have preferred areas for injections or CGMs, but you may have to use other areas to give your favorite spots a chance to heal. For example, some people use their arms in the morning for injections and then their legs for the evening. You might use your abdomen for pump sites in April and then your upper glutes for May. Mix it up!
- Avoid hot showers: Diabetes can make it harder to keep your skin hydrated. Hot showers and low-quality scented lotions or soaps can irritate and dry out your skin. Turn the temp down a little bit!
- Sunscreen is a must: Sunburns can raise your blood glucose levels! A moderate sunburn increases inflammation. This triggers the release of extra cortisol to help your body cope with that inflammation. Cortisol tells your liver to release stored sugar, spiking your blood glucose levels. Sunscreen or UV-protective clothing is a must. Vitamin D deficiency does play a role in insulin resistance and diabetes risk — but experts say it’s unlikely you’ll get enough from the sun unless you live relatively close to the equator. Instead, consider daily vitamin D supplements.
- Check your feet every night: A simple blister, cut, or in-grown toenail can easily become infected, especially if you have chronically high blood glucose levels. That infection can threaten the safety of your entire foot or leg. People with neuropathy are especially at risk of infection because decreased blood flow means simple cuts or blisters aren’t getting the oxygen and nutrients they need to heal well. Checking your feet every night for cuts is a critical part of diabetes management, especially if you have neuropathy. If you spot any slow-healing areas, pus, or discoloring, talk to your healthcare team immediately.
These are little steps, but they make a difference. Prioritizing your daily skin care means protecting yourself from skin-related complications.
Get More Water: It Helps Your Skin Heal!
No, coffee and diet soda don’t count! It’s time to take your water intake seriously! If you aren’t drinking water (or seltzer) throughout the day, your skin is begging you to start. Water plays a huge role in the health of your skin.
(Did you know dehydration actually increases the concentration of glucose in your bloodstream? Water is important for your blood glucose levels, too!)
Your entire body relies on having enough water to transport vital nutrients, manage your body temperature, lubricate critical areas (eyes, nose, mouth, etc.), and even serve as a shock absorbent.
But drinking enough water affects your skin’s ability to heal, too.
Think about how many times a day or week you are puncturing your skin as a person with diabetes. You’re so used to it that you forget that your body wasn’t designed to have an infusion site or CGM sensor sitting in it for days on end.
The skin throughout your entire body relies on your water intake to help it take care of itself! If you aren’t getting enough, you’re inevitably making it harder for your skin to heal. Drink up!
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