Among 120 patients, 10 subjects suffered from chronic itchy dermatological disorders (atopic dermatitis and psoriasis) and one patient was newly diagnosed with notalgia paresthetica. Exclusion criteria included: mental status changes deeming the patient unable to make a detailed assessment of itch, a history of chronic itch of another origin and treatment with antipruritic drugs (including drugs for peripheral neuropathy such as gabapentin and pregabalin). The inclusion criteria were diagnosis of DM2 according to internationally accepted criteria and an informed written participation agreement. We approached 250 consecutive adult patients who were either treated due to diabetes in the University Hospital in Wroclaw or were patients treated in the outpatient unit, among whom 120 agreed to participate in the study (response rate: 48%).
The project was approved by the local Ethical Committee (ST.C260.18.019). This prospective cross-sectional study was performed between April 2019 and March 2021 with a break due to the COVID-19 pandemic situation (April 2020–September 2020). This study aimed to evaluate the prevalence of itch in the adult population of patients with DM2, using standardized methods for itch assessment, as well as to provide itch characteristics and to explore potential underlying causes. The occurrence of itch in DM ranges from 18.4 to 27.5% however, the exact prevalence is not known, as most studies used inconsistent definitions and various tools for itch evaluation and included heterogeneous diabetic populations. However, researchers have recently suggested that the etiology of itch in DM is additionally involved with both dermatologic and neurologic components.
Diabetic feet itch skin#
IFSI classifies itch in diabetes as systemic itch arising on non-inflamed skin or normal-appearing skin. According to the International Forum for the Study of Itch (IFSI), we may divide the etiologic classification of chronic itch to 6 categories: (I) dermatologic, (II) systemic, (III) neurologic, (IV) psychogenic/psychosomatic, (V) mixed, and (VI) others. Ĭhronic Itch (CI) is defined as an unpleasant sensation that leads to intensive scratching lasting 6 weeks or longer. Type 2 diabetes mellitus (DM2) comprises most cases of all DM and is largely the result of excess body weight and physical inactivity. Pathogenesis of itch in DM is not fully understood, although in DM, the underlying pathophysiology, course of disease, comorbidities, complications and treatment used all tend to predispose patients to itch development. DM constitutes a worldwide public health problem affecting 382 million people (8.3% of the world’s population) in 2013 with a projected increase to 592 million people (10.1%) in 2035.
Due to these reasons, physicians treating patients with DM may underestimate its frequency and clinical meaningfulness. Conclusions: We suggest that the primary cause of itch is prolonged poor diabetes control with altered glucose and insulin levels, subsequently causing skin dryness and neuropathy in long-lasting DM2.ĭespite the growing interest in itch, data on itch in diabetes mellitus (DM) is rather limited and mostly based on outdated studies. Itchy subjects had significantly higher scores in both anxiety and depression dimensions of HADS (in each p < 0.01). The mean ItchyQol score was assessed as 41.2 ± 13.4 points, indicating mild life quality impairment and correlated positively with itch intensity. Skin xerosis was significantly more advanced in patients with itch compared to those without ( p < 0.01). Patients with itch had a significantly higher possibility of neuropathy compared with non-itchy subjects ( p < 0.01). Itchy patients have had significantly higher FPG levels compared with the non-itchy population ( p = 0.01). Results: Itch occurred in 35.8% of adult patients with DM2, with NRS max three days 6.31 ± 2.16 and 8.1 ± 3.5 points in 4IIQ.
Neuropathy was assessed using the clinical Katzenwadel neuropathy scale. Skin dryness was evaluated clinically and by non-invasive assessment of epidermis moisturizing. Standardized questionnaires were completed in order to assess the itch intensity and the Four-item Itch Questionnaire (4IIQ) and to assess the psychological impact of itch.
Methods: The study group consisted of 109 adult patients with DM2. This study aimed to evaluate the clinical characteristics of itch in the adult population with DM2 and explore potential underlying causes. Background: Despite growing interest in itch, data regarding itch in type 2 diabetes mellitus (DM2) are still limited, and mostly based on outdated studies.
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