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August 11, 2003

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Question from Irving, Texas, USA:

My five year old daughter, diagnosed with type 1 diabetes three years ago, keeps getting sores that hurt when they are touched. They swell up and have pus inside them that is an off white color, the surrounding area is red (gets worse every day) and is the size of her fist. The doctor says that they are infected bug bites, but I spray her and the other kids down with bug spray before we go outside, and my other kids (who do not have diabetes) do not get them. Could her having diabetes be the cause of these or is it something else?

Answer:

From: DTeam Staff

It certainly is hard to diagnose skin issues via this forum. You did not indicate how well controlled your daughter’s diabetes is. If she is fairly well controlled, for instance, hemoglobin A1c values less than 8%, then I’d say the diabetes has little do with these infected carbuncles. If she is not well controlled, then her diabetes may play a role: germs love sugar.

I would suggest the following:

Really try to tighten her control.
Really strive for clean skin! Have her wash and bathe regularly with an antibacterial soap (examples include Dial, Safeguard, and others that will specifically note “antibacterial” on the label.)
The doctor may want to see if your daughter is a chronic carrier for certain skin germs (such as Staph) in the nose and ears. A referral to an infectious disease specialist or immunologist may be helpful. A referral to an immunologist may be helpful also. Her primary care doctor or pediatric endocrinologist can guide you.

DS