Passage of Glucose: Through Decornified (Stripped) Skin

Abstract

There have been many estimations of the glucose content of full thickness skin by measurement of reducing substances. Urbach 1 found that the level of skin glucose lagged behind that of blood glucose both in rise and fall. Schulze and Kunz 2 employed the quantitative method of estimating the phenylglucosazon derivatives of glucose to show that only about 10 per cent of the reducing substances of sweat and surface film was glucose. Lobitz and Osterberg, 3 studying palmar sweat, concluded that there is very little reducing substance in sweat and that the sweat gland is a good barrier for these compounds. Rothman 4 gives an excellent review of the various skin glucose levels which have been reported, including those of full thickness skin and skin surface film.Miller and Ridolfo 5 in i960 reported the results of using glucose oxidase impregnated paper* for measuring the skin-surface glucose of the fingertips of normal and diabetic subjects. They reported no consistent correlation between hyperglycemia, glycosuria, and elevated skin-surface glucose. Further application of the technic by Tilling 6 in Germany failed to show any reliable relationship between fingertip glucose and blood glucose.The present investigation was undertaken in an attempt to explain these apparent inconsistencies and to develop a method which would show the expected parallelism between the skin and blood sugar. To do this, advantage was taken of the discovery by Pinkus 7 that repeated application to the skin of cellophane tape would remove the stratum corneum and stratum lucidum; and of Monash and Blank's 8 work which showed the marked increase in water loss with removal of this barrier. The working hypothesis was that removal of the outer layer would open the internal milieu of the body to rapid, easily observable measurements of glucose levels.The high degree of specificity of the glucose oxidase

The aerobic cutaneous microflora of diabetic subjects

“…Diabetes mellitus has long been recognized as a predisposing factor in superficial and systemic fungal infections, particularly candidiasis and mucormycosis (Baker, i960;Landau & Newcomer, 1962), while infective cutaneous complications, such as vulvitis, balanitis, and pyoderma arise frequently (Younger, 1965). In diabetes, there is an increased glucose store in the dermis (Rothman, 1954;Fusaro & Goetz, 1971), and the level of cutaneous free-glucose is higher than in the general population, particularly when blood glucose levels are over 180 mg/iooml, for epidermal glucose levels are related to blood glucose levels (Shragger, 1962;Zaias, Shragger & Cushner, 1963).…”