Haut und Diabetes

Late complications of diabetes mellitus are more closely related to the duration of the condition than the patient's age. Nevertheless, it must be assumed that elderly patients are more often affected due to the long latency periods of these late complications. This also applies to diabetes-induced disorders of the skin and its appendages. Chronic hyperglycemia, but also hyperlipoproteinemia, insulin restistance and hyperinsulinaemia affect the skin and the related accessory organs in patientes with diabetes mellitus. In this context, new insights into the regulation of extracellular matrix proteins and of the celluar immune system have been accumulated in recent years. Furthermore, also the sequelae of diabetes, in particular diabetic neuropathy generate alterations of the skin. Paradigmatically, the complex disease syndromes of the diabetic foot, but also of diabetic cheiropathy are discussed in detail. Finally, evidence has been obtained recently that the insulin dependent variety of diabetes mellitus is associated with a specific type of skin pigmentation. Increased UV-light-reactivity, blue eye color and low skin pigmentation seem to predispose for the immune mediated type I- diabetes, perhaps also to other autoimmune diseases.