Necrobiosis Lipoidica Diabeticorum (NLD)? This term is a mouthful and a tongue twister. It is a veritable etymologist dream. No. we are not about to devote 26 pages of expensive real estate to this medical condition. Rather, we want to get real with the issue of the skin and diabetes in general.

The skin protects us from the harsh external environment and controls evaporation and regulates our body temperature, amongst other functions. The skin is alive. It is the largest organ in the human body.

The average person owns 1.5 to 2m of this "real estate-in-perpetuity." The average 6.5cm of skin (i.e. one square inch) alone is populated by over 600 sweat glands and over 1000 nerve endings.

Diabetes is associated with a host of dermatological (skin) conditions. Necrobiosis Lipoidica Diabeticorum (NLD) is but one. Then there's diabetic dermatopathy and, of course, the more common fungal (candida ) skin infection.

To those with diabetes out there, the more perplexing problem is not pronouncing or spelling NLD but questions such as "Do I use moisturising lotion on my skin everyday?" or "Do I need to take health supplements to improve my skin?" or "What do I do if I have a pin prick?".

Indeed, a tiny pin prick may hardly be a thorny issue to most but if you have diabetes, it can mean something as serious as cellulitis (not cellulite). Cellulitis is an acute inflammation of the tissue below the skin surface due to a bacteria infection. It presents with redness, warmth, swelling and pain of the infected area.

Don't lose life and limb. We ignore our largest bodily asset at our own peril. As for Necrobiosis Lipoidica Diabeticorum, if you are intrigued, perplexed or into rare diseases with exotic names, look just a little deeper.
 

Dr Yeo Kim Teck
Editor, Diabetes Singapore

Senior Consultant
Singapore National Eye Centre