PATTERN OF CUTANEOUS MANIFESTATIONS AND THEIR ASSOCIATION WITH GLYCAEMIC CONTROL AND DURATION OF DIABETES MELLITUS: A HOSPITALBASED CROSS-SECTIONAL STUDY

Abstract

Background: Cutaneous abnormalities are common in diabetes mellitus and may reflect chronic hyperglycaemia, insulin resistance, infection susceptibility, neuropathy, or vascular injury. Recognition of these findings during routine care can provide clinically useful clues to metabolic control and systemic complications. Objectives: To describe the clinical and pathological spectrum of cutaneous manifestations in patients with diabetes mellitus and to examine their relationship with glycaemic control and duration of diabetes. Materials and Methods: This hospital-based cross-sectional analytical study included 50 patients with diabetes mellitus evaluated at Shri Sathya Sai Medical College and Research Institute, Tiruporur, during 2024–2025. Demographic characteristics, type and duration of diabetes, treatment, fasting and postprandial glucose, glycated haemoglobin (HbA1c), body mass index, cutaneous findings, and documented diabetic complications were assessed. Histopathological, scraping, culture, or surgical specimen findings were considered when clinically available. Continuous variables were compared using the Mann–Whitney U test and categorical associations using Fisher’s exact test. Results: The mean age was 49.16±11.62 years, and 45 (90.0%) patients had type 2 diabetes. Cutaneous manifestations were present in 43 (86.0%) patients. Xerosis was most frequent (82.0%), followed by diabetic dermopathy (70.0%), acanthosis nigricans (56.0%), pruritus (54.0%), candidiasis (54.0%), dermatophytosis (36.0%), bacterial infection (36.0%), skin tags (34.0%), and diabetic foot lesions (18.0%). Patients with cutaneous manifestations had higher median HbA1c [8.8% (IQR 7.7–10.25) versus 6.7% (IQR 6.45–6.9)] and longer diabetes duration [11.0 years (IQR 6.5–17.0) versus 2.0 years (IQR 2.0–3.5)]; both p<0.001. Manifestations occurred in 1/7 (14.3%) patients with HbA1c <7.0%, 22/23 (95.7%) with HbA1c 7.0–8.9%, and all 20 patients with HbA1c ≥9.0%. Conclusion: Cutaneous involvement was frequent and was strongly associated with poorer glycaemic status and longer duration of diabetes in this cohort. Routine skin examination, coupled with selective pathological confirmation of atypical or complicated lesions, may support earlier recognition of infection, neuropathic or vascular injury, and inadequate metabolic control.