Diabetes-associated dermatological manifestations in primary care and their association with vascular complications
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RESEARCH ARTICLE
Diabetes-associated dermatological manifestations in primary care and their association with vascular complications Jean-Eudes Trihan 1
&
Damien Lanéelle 2 & Neil Metcalfe 3 & Antonia Perez Martin 4 & Pierre Frances 5
Received: 16 April 2020 / Accepted: 24 July 2020 # Springer Nature Switzerland AG 2020
Abstract Introduction Although type 2 diabetes mellitus (DM) is a global public health problem, the diabetes-associated dermatological (non-infectious) manifestations (DADM) remain poorly understood and under-diagnosed. We aimed to evaluate the prevalence of 7 known DADM in a primary care setting, and their association macro/microvascular complications. Methods Cross-sectionnal study included patients consulting in general practice for DM-follow up, from November 2016 to January 2017. Patients aged 10 years), up to 40 years of evolution, reinforcing the link with microvascular complications of which frequency increases proportionally with the duration of DM. This raises the question of possible overestimation of the frequency of this dermatosis by recruitment bias, because all the studies on this subject, to date, have been carried out in hospitals. It is therefore legitimate to think that patients requiring hospital care are those with a long history of diabetes mellitus or difficult to control. This study has several limitations. First, the 2 physicians who carried inclusions were general practionniers, leading to potential bias in diagnostic. However, they both received years of dermatology training and one is an active publishing author regarding dermatological diagnosis and management. Second, this study is monocentric with a general practice based in a semi-urban area; hence, the included patients may not be reprensentative of the entire ambulatory population. Third, no causality links can be affirmed between DMassociated dermatological manifestations and vascular involvement as the study design is cross-sectionnal.
Conclusion This study shows the importance of a complete skin examination of each diabetic patient followed in primary care, as DMassociated dermatological manifestations seems be have similar prevalence rates compared to a tertiary setting (based on data from litterature). These manifestations are frequent with a global prevalence of 35.7%, and seems associated to vascular complications. To our knowledge, this study provides the first estimate of prevalence rates of DM-associated dermatological manifestations in a primary care setting.
J Diabetes Metab Disord
Compliance with ethical standards
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Conflict of interest The authors declare no conflicts of interest relevant to this article to disclose.
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Financial disclosure The authors have no financial relationships relevant to this article to disclose.
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