Diabetes, a chronic disease that disrupts how the body processes glucose, often inflicts damage silently on organs and tissues over years, but it also emits visible warnings on the body’s surface. Brazilian health reports highlight that the skin is frequently among the first organs to show clear signs of the disease, such as dark patches, unusual spots and infections that can appear on the feet, eyes and other areas. These external clues can alert individuals unaware they are living with dangerously high blood sugar.

Yet the very technologies designed to manage diabetes can also cause skin problems, according to a multicentre study published in the journal Hormone Research in Paediatrics. Researchers including a team from Brazil’s University of Campinas tracked 1,719 children and adolescents using insulin pumps or continuous glucose sensors. They found that 52 per cent of pump users and 30 per cent of sensor users experienced skin issues — irritation, eczema and scarring — over just four weeks. The findings, drawn from 22 centres globally, underline the need for improved materials and skin-care protocols as these life-saving devices become standard.

Dietary advice for controlling diabetes is equally contested. In the United States, some obesity medicine specialists are openly sceptical of low-carbohydrate diets. Nate Wood, a physician at the Yale School of Medicine, says he has never recommended a low-carb regimen to a patient and has no plans to do so, citing risks that can outweigh the initial weight loss. Conversely, nutritionists in Iran advise diabetics to focus on low-glycaemic foods, abundant vegetables and reduced simple carbohydrates, especially during hot summer months when dehydration can complicate glucose control. They single out certain fruits — for instance, a sweet but low-sugar variety — as safe hydrating options. New research published in Current Developments in Nutrition adds that daily avocado consumption may lower the glycaemic load of one’s overall diet, a metric that captures both the quantity and quality of carbohydrates consumed.

In Southeast Asia, the approach is more behavioural. Indonesian health commentators note that obesity — a key driver of diabetes — requires gradual lifestyle change rather than extreme, short-lived diets. For men with obesity, simple habits such as portion control, regular physical activity and avoiding skipping meals are promoted as sustainable ways to cut weight and reduce metabolic risks. This contrasts with the Western enthusiasm for rapid-fix diets, underscoring how cultural attitudes shape medical advice.

Looking ahead, the convergence of dermatological and nutritional evidence points to a more holistic model of diabetes care. Clinicians in different regions are recognising that management must go beyond glucose numbers to encompass skin integrity and cultural dietary patterns. As sensor technology spreads and diets globalise, integrating these insights will be critical to prevent the visible — and invisible — complications of a disease that already burdens over half a billion people worldwide.