Itch in diabetes: a common underestimated problem

Introduction
Diabetes mellitus is associated with several skin manifestations, however the association with itch remains unclear.

Aim
To present a detailed literature review in order to analyse the frequency, pathogenesis, and course of itch in diabetes mellitus.

Material and methods
Data were collected from the PubMed and Cochrane databases. Articles were excluded if the populations presented with comorbidities or received treatment with drugs affecting the skin. Also, animal studies, studies with poor methodology and pilot studies were excluded.

Results
Among the 5 original articles included, the epidemiology of itch in diabetes varies from 18.4% to 27.5%. Two main factors are associated with the pathogenesis of itch in diabetes, namely skin xerosis and diabetic polyneuropathy. It is still poorly defined how glycaemic control is associated with generalized itch. No treatment of choice is available; however, topical therapy (emollients) provides significant relief in varying percentages of patients.

Conclusions
The results indicate a benefit of diabetes screening in individuals presenting with chronic itch without primary skin lesions.