Relation between cutaneous and extracutaneous complications in pediatric patients with type 1 diabetes

Figures & data

Table 1. Demographic and laboratory characteristic of studied patients and healthy controls.

	Patients with type1 diabetes (N = 80)	Healthy controls (N = 50)	P - Value
Gender [N (%)] Female	32 (40%)	18(36%)	P = 0.64
Male	48(60%)	32(64%)
Age (years) [mean ± SD]	11.69 ± 4.34	12.2 ± 2.12	P = 0.44
Onset of diabetes(years) [mean ± SD]	5.70 ± 3.85
Duration of diabetes (years) [mean ± SD]	6.18 ± 3.69
BMI (kg/m2) [mean ± SD]	23.7 ± 2.4	24.1 ± 1.7	P = 0.31
Mean HbA1c (%) [mean ± SD]	9.01 ± 1.37
HbA1c IFCC (mmol/mol)	75
Presence of microvascular complications
Diabetic nephropathy[N (%)]	40(50%)
Retinopathy [N (%)]	0
Neuropathy [N (%)]	0

* All patients with diabetic nephropathy had microalbuminuria with a mean of 41.72 ± 20.44 mg/24 hr, none had macroalbuminuria.

Table 2. Distribution of cutaneous disorders in relation to microalbuminuria.

	Patients with type 1 diabetes (N = 80)	Patients with microalbuminuria (N = 40)	Patients with normoalbuminuria (N = 40)	Healthy controls (N = 50)	P - Value
Infections
Fungal [N (%)]	32(40%)	21(52.5%)(65.6%)	11(27.5%)(34.6%)	9(18%)	P1<0.01
					P2 = 0.02
Candidiasis [N (%)]	23(28.75%)	16(40%)(69.6%)	7(17.5%)(30.4%)	3(6%)	P1<0.01
					P2 = 0.03
Tinea unguium [N (%)]	14(17.5%)	11(27.5%)(78.6%)	3(7.5%)(21.4%)	2(4%)	P1 = 0.02
					P2 = 0.02
Tinea pedis[N (%)]	10(12.5%)	8(20%)(80%)	2(5%)(20%)	2(4%)	P1 = 0.1
					P2 = 0.04
Bacterial [N (%)]	19(23.75%)	14(35%)(73.7%)	5(12.5%)(26.3%)	5(10%)	P1 = 0.047
					P2 = 0.02
Viral [N (%)]	7(8.75%)	3(7.5%)(42.9%)	4(10%)(57.1%)	5(10%)	P1 = 0.81
					P2 = 0.69
Cutaneous manifestation associated with diabetes
Xerosis [N (%)]	24(30%)	21 (52.5%) (87.5%)	3(7.5%)(12.5%)	4(8%)	P1<0.01
					P2<0.01
Necrobiosis lipoidica [N (%)]	2(2.5%)	2(5%)(100%)	0(0%)	0(0%)	P1 = 0.5
					P2 = 0.5
Rubeosis faciei [N (%)]	7(8.75%)	7(17.5%)(100%)	0(0%)	0(0%)	P1 = 0.04
					P2 = 0.01
Other cutaneous disorders
Pruritus [N (%)]	16(20%)	9(22.5%)(56.25%)	7(17.5%)(43.75%)	6(12%)	P1 = 0.03
					P2 = 0.58
Keratosis pilaris [N (%)]	14(17.5%)	12(30%)(85.7%)	2(5%)(14.3%)	2(4%)	P1 = 0.022
					P2<0.01
Atopic dermatitis [N (%)]	4(5%)	0(0%)	4(10%)(100%)	4(3%)	P1 = 0.7
					P2 = 0.12
Acne [N (%)]	12(15%)	5(12.5%)(41.7%)	7(17.5%)(58.3%)	7(14%)	P1 = 0.69
					P2 = 0.53
Pigmentary lesions[N (%)]	11(13.75%)	7(17.5%)(63.6%)	4(10%)(36.4%)	3(6%)	P1 = 0.16
					P2 = 0.33

P1 = represents the difference between diabetic cohort and healthy controls. P2 = represents the difference between both diabetic cohort with and without DN.

* = reflects the percentage of cutaneous disorder in patients with DN in relation to total recruited diabetic cohort.

** = reflects the percentage of cutaneous disorder in patients without DN in relation to total recruited diabetic cohort.

Figure 1. Effect of glycemic control and disease duration among patients with fungal and bacterial infection. Figure (1A) showed that patients with fungal infection had significantly higher HbA1c with a mean value of 10.98 ± 1.6% compared to 8.33± 2.6%(P = 0.01), additionally these patients had longer disease duration with mean of 8.07± 3.8 years compared to 6.19 ±2.9 years(P<0.01). Figure (1B) illustrated highly significantly values of HbA1C in patients with bacterial infections with a mean value of 12.2 ± 1.4% compared to 7.45± 3.9% (P < 0.01) in patients with no bacterial infection (Fig. 1B).

Figure 2. Correlation between xerosis and HbA1C. Stepwise logistic regression showed that xerosis best correlated with patients' glycemic control (R = 0.66, p < 0.01, β-coefficient = 0.103).