Endocrine Abstracts

JOINT287

Background: The psychological burden of diabetes remains largely underestimated. Often perceived as an intimate tragedy, it can manifest outwardly through self-destructive behaviors such as self-harm. Diabetic patients are consequently at a heightened risk of mortality associated with severe psychiatric disorders, including suicide. Early and tailored intervention is essential to mitigate these adverse outcomes.

Case Reports: Case 1: A 50-year-old woman with a long-standing history of type 1 diabetes since childhood, managed with insulin therapy, experienced multiple hospitalizations due to poorly controlled diabetes. Her medical history included a lacunar ischemic stroke and hypertension. During her hospital stays, she presented with polymorphic skin lesions, including excoriations, linear scratches, and occasionally lichenified ulcers, predominantly on her arms and legs. These lesions were attributed to intense pruritus. A skin biopsy excluded cutaneous leishmaniasis. The lesions were suspected to be exacerbated during episodes of metabolic decompensation. Following the exclusion of systemic causes, a diagnosis of psychogenic pruritus was established. Case 2: A 48-year-old woman with a two-year history of type 2 diabetes and hypertension presented with a four-month history of skin lesions localized to her legs, characterized by ulcers and linear scratch marks. A skin biopsy revealed no abnormalities. The patient reported experiencing severe itching episodes, particularly during acute metabolic decompensations.

Conclusion: Psychiatric disorders are significantly more prevalent among diabetic patients compared to the general population. Routine screening for anxiety and depressive symptoms is imperative in this vulnerable group to ensure timely and effective management, thereby reducing their psychological and physical burden.