Frequency and association of dermatological manifestations of type 2 diabetes mellitus with body mass index and HbA1c levels

uzma sarwar, Lt Col(R) dr Habib ur Rehman, sumara rashid, Muhammad Azam Bokhari


Objective To determine the frequency of cutaneous manifestations in patients suffering from type 2 diabetes mellitus and to observe the association of these manifestations with body mass index (BMI) and glycosylated hemoglobin (HbA1c) level.


Methods This cross-sectional study was conducted in Shalamar Teaching Hospital / Shalamar Medical and Dental College, Lahore from October 2016 to March 2017. A total of 200 adult patients belonging to both genders having type 2 diabetes mellitus attending the outpatient department were studied. Detailed history and cutaneous examination was performed after taking the informed consent. Glycemic profiles including HbA1c were done. Height and weight were recorded too. Normal range of HbA1c was taken as 5 - 6.5 %. Value of ≥ 6.5 % was taken as high. Normal range of BMI as taken as 18.5- 24.9 kg/m2. Patients having BMI 25-29.9 kg/m2 were taken as overweight and ≥ 30 kg/m2 as obese.


Results Of 200 patients, 174 (87%) patients were found to have cutaneous abnormalities. There were 53 (26.5%) males and 147 (73.5%) females. Mean age was 52.4±9.96 years. Mean HbA1c was 9.07±2.23%. The mean BMI was 29.46 kg/m2 with 20% having normal BMI, 38% were overweight and 41% were obese. Most frequently observed skin disease was cutaneous infections including bacterial and fungal infections, followed by generalized xerosis, diabetic dermopathy, acanthosis nigricans, pruritus and acrochordons. Statistically significant correlation was observed between HbA1c and diabetic foot and between BMI and acanthosis nigricans and generalized xerosis.


Conclusion About 87% patients with type 2 diabetes have cutaneous lesions, the most common of which was cutaneous infections. Hyperglycemia manifested with high HbA1c and obesity manifested with high BMI is associated with many cutaneous lesions.



Dermatological manifestations, type 2 diabetes mellitus, glycosylated hemoglobin, body mass index

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