Skin Lesions in Diabetes Mellitus: A 6-Year Observational Study and 11-Year Longitudinal Analysis of Hospital Admissions from NE Romania

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Abstract
Chronic hyperglycemia profoundly impairs skin integrity, with dermatological complications affecting up to half of patients with diabetes mellitus. The objective of this study was to describe the spectrum, frequency, and clinical characteristics of skin lesions in patients with diabetes mellitus and to evaluate whether specific cutaneous signs are associated with an increased risk of subsequently developing type 2 diabetes. This retrospective observational study evaluated 960 cases admitted to the Dermatology Clinic of “Sf. Spiridon” Emergency County Clinical Hospital, Iași, between 2017 and 2022, complemented by an 11-year longitudinal follow-up (2011–2016). Ulcerative lesions predominated (85.7%), followed by inflammatory manifestations (12.4%), while classical diabetes-specific dermatoses represented 7%) was documented in 94.2% of patients, with the most severe lesions occurring in those with HbA1c > 10%. In the longitudinal analysis, patients who later developed diabetes initially presented significantly higher rates of xerosis, pruritus, and callus compared with the controls. Multivariate logistic regression identified xerosis (OR 4.70) and pruritus (OR 3.41) as independent predictors of future diabetes. These findings suggest that certain dermatological signs may serve as early non-invasive markers of metabolic dysfunction and highlight the importance of routine skin examination in diabetes risk stratification.

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