Itch in diabetes: a common underestimated problem

Abstract

Introduction: Diabetes mellitus is associated with several skin manifestations, however the association with itch remains unclear. Aim: To present a detailed literature review in order to analyse the frequency, pathogenesis, and course of itch in diabetes mellitus. Material and methods: Data were collected from the PubMed and Cochrane databases. Articles were excluded if the populations presented with comorbidities or received treatment with drugs affecting the skin. Also, animal studies, studies with poor methodology and pilot studies were excluded. Results: Among the 5 original articles included, the epidemiology of itch in diabetes varies from 18.4% to 27.5%. Two main factors are associated with the pathogenesis of itch in diabetes, namely skin xerosis and diabetic polyneuropathy. It is still poorly defined how glycaemic control is associated with generalized itch. No treatment of choice is available; however, topical therapy (emollients) provides significant relief in varying percentages of patients. Conclusions: The results indicate a benefit of diabetes screening in individuals presenting with chronic itch without primary skin lesions.

Knowledge, Attitude and Practice toward Pruritus Management among Physicians and Patients Living With Diabetes Mellitus: A Quantitative Survey in India

“…In the present survey, the physicians (CP and endocrinologists) reported the 14% (n = 46) patients with diabetes had pruritus. The results were in accordance with previous published literature, both at the global and regional level where the prevalence of cutaneous manifestations and pruritus in persons living with diabetes have been established [10,[23][24][25][26].…”

“…Further, in patients with elevated blood glucose there is an increase of advanced glycosylated products in the collagen of the dermis leading to pruritus [6]. Globally, 18.4-27.5% diabetes patients present with pruritus [8][9][10][11]. An Indian cross-sectional study conducted in a tertiary care hospital, reported that 13.3% of the diabetes patients had pruritus without skin lesions.…”

Itch in Adult Population with Type 2 Diabetes Mellitus: Clinical Profile, Pathogenesis and Disease-Related Burden in a Cross-Sectional Study

“…However, researchers have recently suggested that the etiology of itch in DM is additionally involved with both dermatologic and neurologic components [ 6 , 7 , 8 ]. The occurrence of itch in DM ranges from 18.4 to 27.5% [ 9 ]; however, the exact prevalence is not known, as most studies used inconsistent definitions and various tools for itch evaluation and included heterogeneous diabetic populations.…”

Itch in Children with Type 1 Diabetes: A Cross-Sectional Study

“…Most researchers classify itch in diabetes, according to the International Forum for the Study of Itch (IFSI), as systemic itch [9]; however, some authors suggested mixed etiology of diabetic itch with the additional involvement of both dermatologic and neurologic components [10][11][12]. Only a few studies investigated the occurrence of itch in DM, reporting a wide prevalence ranging from 18.4-27.5% [13]. However, these studies used inconsistent definitions and various tools for itch evaluation and included heterogeneous diabetic populations.…”