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When the doctor said I had diabetes, I conjured images of languishing on a chaise lounge nibbling on chocolates. I have no idea why I thought this.

— Mary Tyler Moore

I wrote Oct. 15 about skin diseases that could signal the presence of diabetes. But I've personally found that itching or skin irritations in general can be an everyday occurrence for diabetics.

After some more-than-skin-deep investigation, I found information on websites such as those of the American Diabetes Association and the Mayo Clinic suggesting that people with diabetes tend to be itchy at higher rates. Itchiness should not be ignored, because if you scratch enough to open the skin, an infection can develop, and diabetics have trouble fighting off infections.

There are myriad reasons why a person with diabetes might feel itchy. It could be diabetic polyneuropathy or peripheral neuropathy. That's a condition that occurs when high blood glucose damages nerve fibers, particularly those in the hands and feet.

Before the nerve damage sets in, the body experiences high levels of cytokines. The word is derived from two Greek words — "cyto" meaning cell and "kinos" meaning movement. They are cell-signaling molecules that aid cell-to-cell communication in immune responses and stimulate the movement of cells toward sites of inflammation, infection and trauma. An overabundance of cytokines can signal a coming wave of nerve damage.

Another reason for itchiness in diabetics is possible kidney or liver failure. With kidney failure, damaged kidneys don't clear metabolic waste and excess minerals from the blood, and so the body moves liquid in the skin to the bloodstream to offset the too-high mineral level. This leads to skin dehydration, which can cause itching.

Itching from liver disease can appear before signs of primary billiary cholangitis, which is a blockage or obstruction of the bile ducts. Bile is a liquid produced in the liver that is used to help digest fats and remove toxins from the body. It passes out of the liver through the small tubes called bile ducts.

In this cholangitis, the immune system mistakenly attacks those ducts, making them swell and scar. Over time, liver damage gets worse, and the liver could stop working.

But itching doesn't have to mean a looming, deadly disease. It could be:

Athlete's foot. Also called tinea pedis, this contagious fungal infection affects the skin on the feet. It's not serious, but can be hard to cure.

Eczema. This is a term for several types of skin swelling and is often generalized as "dermatitis." It's not contagious but can worsen over time. The skin tends to be dry and easily irritated.

Hidradenitis suppurativa. A disease commonly found in the underarms or on the groin, it can look like pimples, deep acne or boils. It can lead to scarring and become painful, and eventually rupture. Treatment from a doctor is advised.

Psoriasis. This chronic disease of the immune system usually starts under the skin. The overactive immune system triggers skin irritation that causes skin cells to be produced faster than normal. But the body can't shed the old skin cells fast enough, so the new cells pile up on top and that forms the thick, itchy, red flaky patches known as plaques. The exact cause is not known.

Another cause of itching could be a new medication. If you think that's the case, don't stop the medication, just talk to your doctor. If it is an allergic reaction, a replacement medication could be the answer.

Sometimes the problem can be caused by soaps, dyes or perfumes that dry out the skin.

One of the best ways to help skin issues is to manage your diabetes and blood sugar levels.

Avoid hot baths, which can be drying. Apply lotion after drying off, but not between the toes. That and moisture can attract harmful fungi. Stay away from lotions with perfumes or dyes, and look for ones labeled gentle or hypoallergenic. There are some diabetes-specific lotions on the market.

Email me at:

rboggs@arkansasonline.com

ActiveStyle on 10/22/2018

Print Headline: Diabetes can really get under your skin

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