University of Oulu

Sinikumpu, S., Auvinen, J., Jokelainen, J., Huilaja, L., Puukka, K., Ruokonen, A., Keinänen-Kiukaanniemi, S., Tasanen, K., Timonen, M. (2017) Abnormal skin in toe webs is a marker for abnormal glucose metabolism. A cross-sectional survey among 1,849 adults in Finland. Scientific Reports, 7 (1), doi:10.1038/s41598-017-09354-3

Abnormal skin in toe webs is a marker for abnormal glucose metabolism : a cross-sectional survey among 1,849 adults in Finland

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Author: Sinikumpu, Suvi-Päivikki1; Auvinen, Juha2,3; Jokelainen, Jari2,3;
Organizations: 1PEDEGO Research Unit, University of Oulu, Department of Dermatology and Medical Research Center Oulu, Oulu University Hospital
2Unit of General Practice, Oulu University Hospital
3Centre for Life Course Health Research, University of Oulu
4NordLab Oulu, Department of Clinical Chemistry and Medical Research Center Oulu, University Hospital of Oulu
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
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Language: English
Published: Springer Nature, 2017
Publish Date: 2017-09-27


Diabetes is undiagnosed disease and easy screening tools for it are warranted. Because foot complications are usual in diabetes, we aimed to test hypothesis that skin abnormalities are found already from patients who are not aware of having diabetes, by studying the possible association between unhealthy toe web skin and abnormal glucose metabolism. 1,849 cases without previously diagnosed diabetes participated to the 46-year follow-up study of the Northern Finland Birth Cohort. A skin investigation was performed for all, and abnormal skin findings in toe web spaces were taken as explanatory variables. Abnormal glucose tolerance was the main outcome and it was tested with an oral glucose tolerance test (OGTT), glycosylated haemoglobin fraction (HbA1c) Values are numbers (percentages) of sub and fasting blood glucose. The participants who had any abnormal skin findings in toe webs were associated with 2.5-fold (OR 2.5, 95% CI 1.3–4.9) and 6-fold (OR 6.2, 1.4–27.6) increased risk of having previously undiagnosed diabetes detected by a 2-hour OGTT and HbA1c, respectively. The predictive power of toe web findings was comparable with FINDRISC score. Abnormal skin findings in the toe webs show increased risk of occult diabetes, and may, thus serve as an additional sign of undiagnosed diabetes.

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Series: Scientific reports
ISSN: 2045-2322
ISSN-E: 2045-2322
ISSN-L: 2045-2322
Volume: 7
Article number: 9125
DOI: 10.1038/s41598-017-09354-3
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
3123 Gynaecology and paediatrics
Funding: The study was supported by the Oulu University Hospital, the Northern Finland Cancer Association, the Academy of Finland, the Finnish Medical Foundation, the Medical Research Center Oulu, the Finnish Dermatological Society, the University of Oulu and ERDF European Regional Development Fund - Well-being and health: Research in the Northern Finland Birth Cohort 1966 (grant no. 539/2010 A31592, 01.01.2011–31.12.2013). The study sponsors had no role in this study.
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