Prevalence and factors associated with cutaneous manifestations of type 2 diabetes mellitus

Background. Type 2 diabetes mellitus (T2DM) is known to cause multiple systemic manifestations. However, there are limited studies describing cutaneous manifestation among T2DM in Malaysia. The objective of this study was to determine the prevalence of cutaneous manifestation among T2DM patients, types of lesions and its associated factors. Methods. A cross-sectional study was conducted among 271 T2DM patients at a primary care clinic in Kuala Lumpur. Results. More than one third (63.5%) of patients were found to have cutaneous manifestations of T2DM. The most common manifestation was infections (34.7%) followed by Skin Diseases with Weak to Strong Association with Diabetes (SDWSAD) (31.7%), Skin Manifestation of Diabetic Complication (SMDC) (2.2%) and others cutaneous lesions (22.1%). Among the infections, onychomycosis was the commonest type of infection (27.7%) while diabetic dermopathy was the commonest lesion of SDWSAD (29.7%). Males had almost two times the odds of developing cutaneous manifestations of T2DM, compared to females (adjusted odds ratio [AOR]: 1.871, 95% CI: 1.108-3.160; P = 0.019). There was no association between glycemic control and cutaneous manifestations. However, males and those with T2DM duration of five years and more had 2.6 times the odds of developing SDWSAD (AOR: 2.646, 95% CI: 1.506-4.648 P = 0.001) and (AOR: 2.635, 95% CI: 1.107-6.268, P = 0.028) respectively. Those with diabetic neuropathy and peripheral vascular disease (PVD) had very high odds of developing SMDC such as diabetic foot and trophic ulcers (AOR: 23.259, 95% CI: 1.191-454.2, P = 0.038) and (AOR: 102.36, 95% CI: 4.013-2610, P = 0.005), respectively. Conclusion. The knowledge of these cutaneous manifestations increases physician's awareness and prompts early screening to reduce morbidity improve quality of life.