1. Kobos, Ewa PhD

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I read "A Mother and a Nurse" (Best of the Blog, January), about the author's son's diagnosis of type 1 diabetes, with great interest. It inspired me to look at clinical issues related to the diagnosis of diabetes. In the article the author described symptoms that disturbed her and prompted her to seek help. Most of them suggested the possibility of diabetes with significant hyperglycemia: increased diuresis, nocturia, increased thirst, weight loss, and purulent skin infections.


In the case of my five-year-old, a symptom that appeared about four months before diabetes was diagnosed was cutaneous papules on the knee. Because of their progressive character, I was directed to a dermatologist. The diagnosis was granuloma annulare, which is associated with diabetes. A blood test for glucose was performed and the result confirmed diabetes.


Skin lesions are present in about one-third of people with diabetes and often occur well before diabetes is considered, thus playing an important role in diagnosis of the disease.1


Ewa Kobos, PhD


Warsaw, Poland




1. Lima AL, et al Cutaneous manifestations of diabetes mellitus: a review Am J Clin Dermatol 2017 18 4 541-53