Blood Sugar Levels and Skin Issues: A Comprehensive Guide

Q: Blood Sugar Levels and Skin Issues: A Comprehensive Guide

Hello： Based on the blood test data you provided, your current HbA1c (glycated hemoglobin) and fasting blood glucose levels do not meet the criteria for a diabetes diagnosis. <br>Acanthosis nigricans is typically caused by insulin resistance and can be reduced by controlling weig

Blood glucose test

Hello, Doctor! I have some questions regarding my blood sugar issues.
Last year, my hemoglobin A1c was 5.5, and my fasting blood glucose was 85.
Since last year, I have noticed some skin changes that resemble hyperpigmentation.
I had a biopsy done on my arm, and the report indicated post-inflammatory hyperpigmentation.
Similar changes have also appeared on my neck, armpits, and sides of my chest.
Given that my grandmother has diabetes, I wondered if this could be related to insulin resistance causing acanthosis nigricans.
However, the dermatologist mentioned that the color does not appear typical for that condition and suggested it looks more like hyperpigmentation or a fungal infection.
I was prescribed medication to apply, and if the condition does not improve and continues to spread, I should seek further evaluation at a larger hospital.
Additionally, after bowel movements, I notice that the water appears clear from above, but from certain side angles, I often see a shiny, oily substance.
I have a bowel movement once a day, and my stools were previously softer and occasionally unformed, but now they are harder.
Sometimes, I experience gastrointestinal discomfort both on an empty stomach and after meals.
I underwent gastroscopy and colonoscopy, and the doctor indicated that everything was normal.
Later, I had blood tests done, which showed my hemoglobin A1c at 5.8 and fasting blood glucose at 88, with an insulin level of 4.3.
I would like to ask if the issues related to my skin, gastrointestinal system, and bowel movements could be connected to my pancreas.
Are these blood test results indicative of prediabetes? I appreciate your time and insights! Thank you!

zh, 40~49 year old female. Ask Date: 2020/08/10

Dr. Wu Zongying reply Family Medicine

Hello: Based on the blood test data you provided, your current HbA1c (glycated hemoglobin) and fasting blood glucose levels do not meet the criteria for a diabetes diagnosis.
Acanthosis nigricans is typically caused by insulin resistance and can be reduced by controlling weight, managing waist circumference, and engaging in regular exercise.
Since I have not seen the appearance of your skin, I cannot definitively say whether it is acanthosis nigricans.
However, based on your blood glucose and HbA1c levels, a diagnosis of diabetes cannot be made at this time.
I recommend focusing on your diet, weight, and exercise to reduce the risk of developing diabetes in the future.
Wishing you good health.

Reply Date: 2020/08/10

More Info

Understanding the relationship between blood sugar levels and skin issues is crucial, especially for individuals who may have a family history of diabetes or are experiencing skin changes that could be indicative of underlying metabolic conditions. Based on the information you've provided, let's delve into the potential connections between your blood sugar levels, skin conditions, and gastrointestinal symptoms.

Blood Sugar Levels and Skin Conditions
Your glycosylated hemoglobin (HbA1c) levels of 5.5% and 5.8% are within the normal range, indicating that your average blood sugar levels over the past two to three months are well-controlled. A fasting blood sugar of 85 mg/dL and 88 mg/dL also falls within the normal range. However, the presence of skin issues such as post-inflammatory hyperpigmentation (PIH) and potential acanthosis nigricans (often associated with insulin resistance) raises some concerns.

Post-Inflammatory Hyperpigmentation: This condition occurs when the skin darkens in response to inflammation or injury. If you have experienced any form of skin trauma, irritation, or inflammatory skin conditions (like acne or eczema), it could lead to this pigmentation. The areas you mentioned—arms, neck, and chest—are common sites for such changes, especially if they have been subjected to friction or irritation.

Acanthosis Nigricans: This condition is characterized by dark, velvety patches of skin, typically found in body folds such as the neck, armpits, and groin. It is often associated with insulin resistance, which can be a precursor to type 2 diabetes. While your dermatologist suggested that the coloration does not appear typical for acanthosis nigricans, it is still worth monitoring, especially given your family history of diabetes.

Gastrointestinal Symptoms
Your gastrointestinal symptoms, including changes in stool consistency and discomfort, could also be linked to dietary habits, stress, or other underlying conditions. The presence of an oily sheen on the water's surface after a bowel movement may suggest fat malabsorption, which could be due to various factors, including pancreatic insufficiency or dietary fat intake.

The fact that you have undergone endoscopy and colonoscopy without any significant findings is reassuring. However, if you continue to experience discomfort or changes in bowel habits, it may be beneficial to consult a gastroenterologist for further evaluation, including tests for malabsorption syndromes or food intolerances.

Insulin Resistance and Diabetes Risk
Given your family history of diabetes and the symptoms you are experiencing, it is prudent to remain vigilant about your metabolic health. While your current blood sugar levels do not indicate prediabetes, it is essential to monitor them regularly, especially if you notice any changes in your weight, energy levels, or skin conditions.

Recommendations
1. Regular Monitoring: Continue to monitor your blood sugar levels and HbA1c periodically. If you notice any significant changes, consult your healthcare provider.

2. Skin Care: For the hyperpigmentation, consider using topical treatments that contain ingredients like hydroquinone, retinoids, or vitamin C, which can help lighten dark spots. Always consult with your dermatologist before starting new treatments.

3. Diet and Lifestyle: Focus on a balanced diet rich in whole foods, fiber, and healthy fats, which can help manage blood sugar levels and support overall health. Regular physical activity is also crucial for maintaining insulin sensitivity.

4. Gastrointestinal Health: If gastrointestinal symptoms persist, consider keeping a food diary to identify any potential triggers. Discuss with your doctor about further gastrointestinal evaluations if necessary.

5. Follow-Up: If your skin condition worsens or new symptoms arise, seek further evaluation from a dermatologist or an endocrinologist who can provide a comprehensive assessment of your metabolic health.

In conclusion, while your current blood sugar levels are normal, the skin changes and gastrointestinal symptoms warrant close observation and possibly further investigation. Maintaining a proactive approach to your health will be beneficial in managing any potential risks associated with insulin resistance and diabetes.

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