The Prevalence and the Associated Factors of Cutaneous Manifestations in Chinese Patients with Type II Diabetes Mellitus in a Primary Care Diabetes Clinic in Hong Kong

Studies suggested that cutaneous manifestations in diabetes patients were prevalent (62.5% to 88.3%). Acute metabolic derangements and chronic complications were postulated to cause many skin diseases in diabetes patients. Most of the skin diseases can be prevented and cured if detected and treated early. However, the local prevalence data was insufficient. It is important to raise the awareness of primary care physicians on these under-investigated conditions through this study. Objectives (1) To evaluate the prevalence of cutaneous manifestations in Chinese patients with type II diabetes mellitus in a primary care diabetes clinic. (2) To study the associated factors of these cutaneous manifestations. Methodology: This was a cross-sectional study carried out in a diabetes clinic in primary care. All Chinese patients who attended the clinic from 13th July 2017 to 23th November 2017 were recruited. For patients agreed to participate in the study, detailed skin history, physical examination, investigations and treatment would be offered accordingly. Clinical findings were documented in a consultation template. Relevant demographic data and latest clinical parameters were retrieved from computerized medical records. Results: 271 patients were recruited. 52.8% of the subjects were male. The mean duration of diabetes history was 13.5 years. The mean Glycated Haemoglobin (HbA1c) level was 8.0%. 32.5% of patients were put on insulin. 74.9% of patients were overweight or obese. The prevalence of cutaneous manifestations was 59.4%. The most common groups of skin diseases were skin infections (43.6%), other skin diseases not known to be associated with diabetes such as atopic eczema and seborrheic keratosis (29.4%) and skin diseases associated with diabetes such as acanthosis nigricans, diabetic dermopathy and diabetic thick skin (24.6%). Fungal skin infections and xerosis were the two most common diagnoses. Male gender and higher Body Mass Index (BMI) were found to be statistically significant risk factors of skin diseases with OR 1.79 (CI 1.08-2.96) and OR 1.08 (CI 1.02-1.16) respectively. Conclusion: Skin diseases were prevalent in Chinese diabetes patients. Male gender and higher BMI were the main associated risk factors. Weight control may be important to prevent some skin diseases in diabetes patients.