The Prevalence of Diagnosed Cutaneous Manifestations during Ambulatory Diabetes Visits in the United States, 1998–2002

Background: The prevalence of diabetes has been rapidly increasing. Previous reports indicated that diabetics are prone to certain cutaneous diseases. Objective: To determine the frequencies of diagnosed skin conditions during ambulatory diabetes visits in the USA. Methods: We evaluated two national ambulatory medical care surveys between 1998 and 2002 and compared the diagnoses of 7 categories of skin conditions in diabetics (n = 9,626) to patients with hypertension (n = 15,997) or gastroesophageal reflux disease (GERD; n = 2,362) using χ2 tests and multivariate logistic regressions. Results: Diabetics were prone to chronic skin ulcers (odds ratio = 62.5, 95% confidence interval = 3.95–989 compared to GERD; 9.97, 6.34–15.7 compared to hypertension), bacterial skin infections (5.95, 2.86–12.4 compared to GERD; 5.15, 3.74–7.08 compared to hypertension) and fungal skin infections (2.66, 1.15–6.16 compared to GERD; 1.99, 1.32–3.01 compared to hypertension) but not to other skin conditions. These findings remained true during primary care physician visits. Conclusion: Chronic skin ulcers, bacterial and fungal skin infections are more frequently diagnosed in diabetics. We could not verify that other skin conditions are associated with diabetes, in part due to potential underdiagnosis and underreporting.