Search the FAQ Archives

3 - A - B - C - D - E - F - G - H - I - J - K - L - M
N - O - P - Q - R - S - T - U - V - W - X - Y - Z - Internet FAQ Archives

diabetes FAQ: treatment (part 3 of 5)
Section - Necrobiosis lipoidica diabeticorum

( Part1 - Part2 - Part3 - Part4 - Part5 - Single Page )
[ Usenet FAQs | Web FAQs | Documents | RFC Index | Property taxes ]

Top Document: diabetes FAQ: treatment (part 3 of 5)
Previous Document: Alcohol and Diabetes
Next Document: Has anybody heard of frozen shoulder (adhesive capsulitis)?
See reader questions & answers on this topic! - Help others by sharing your knowledge
Necrobiosis lipoidica diabeticorum (NLD) consists of oval plaques, usually on
the lower legs. It may start as small red spots or raised areas, which
develop a shiny, porcelain-like appearance. The plaques often turn a light
color due to extracellular fat (the "lipoidica"). They are often itchy or
painful. Typically the spots turn a brownish color, which fades slowly but
is permanent.

NLD is not related to any other complication of diabetes. In particular, NLD
does not presage eye, kidney or vascular problems.

NLD is much more common in diabetics, who account for perhaps 2/3 of all
cases. Many of the remainder develop diabetes, and NLD should be considered a
warning sign of diabetes. Reports vary widely on exactly who is most at risk.
About 1% of diabetics have some degree of NLD ... plus or minus 1%, depending
on which report you read. Some reports say NLD occurs more often in young
women, but some textbooks disagree.

The real dangers seem to be ulceration, infection, and the stress from the
appearance. Ulceration sometimes occurs spontaneously, and often as a result
of trauma.

Ulceration is often a result of scratching or trauma, and the ulceration from
scratching sometimes heals very slowly. Thus avoiding scratching and trauma
decreases the amount of ulceration, though some ulceration will occur anyway.

There are some images of NDL lesions at

No particularly good treatment seems to be known. Topical steroids (that is,
creams) are the most common first choice. The ulcerations usually heal if
cared for properly, and drastic measures are not called for in most cases.
William Biggs reports that skin grafts may be necessary in cases of severe
ulceration, but do not tend to give results that are cosmetically attractive.

Other treatments reported to help sometimes are oral aspirin, pentoxifylline,
dipyridamole, locally injected steroids, and systemic steroids. No one claims
to be able to predict what will work on any given patient, and often not much
of anything is effective. However, the ulcers usually heal if given
supportive treatment. Surgery should be avoided. Ineke van der Pol reports
finding relief in Chinese herbal treatments.

STEROID WARNING: locally injected and systemic steroids raise blood glucose
and cause severe problems regulating blood glucose. These should be used only
as a last resort. Topical steroids (creams and inhalers) cause no such

Note that treatment is not a medical necessity except for ulcerations and
infections. Otherwise, the purpose of treatment is to prevent ulcerations
and infections, decrease pain and itching, and improve the appearance.

NLD is the subject of occasional articles in scientific journals on diabetes
and on dermatology. Betsy Butler has researched the medical journals, finding
little beyond what I've reported above -- in her words, "no good answers".
_Therapy for Diabetes Mellitus and Related Disorders_, published by the ADA,
has a section on necrobiosis lipoidica diabeticorum and its treatment.

Ineke van der Pol has started a mailing list about NLD at

I thank the following people, especially Betsy, who posted the information
from which I derived this section:

     Betsy Butler Polley (who says sorry, she doesn't have any information
                          besides what's here)
     William Biggs <reddy_biggs(AT)>
     Tari M. Birch <tm_birch(AT)>
     Terence Griffin (who also says he doesn't have any other info)
     Bill Barner <barner(AT)>
     Ineke van der Pol <fluo(AT)> (who has no further information
         but is happy to correspond about NLD if you wish)

User Contributions:

Raqiba Shihab
Report this comment as inappropriate
May 10, 2012 @ 2:14 pm
Many thanks. My husband has Type 2 diabetes and we were a bit concerned about his blood sugar/glucose levels because he was experiencing symptoms of hyperglyceamia. We used a glucometer which displays the reading mg/dl so in my need to know what the difference
between and mg/dl and mmol/l is, i came across your article and was so pleased to aquire a lot more info regarding blood glucose, how to read and convert it.
Report this comment as inappropriate
Aug 11, 2012 @ 9:09 am
It was really informative and useful for people who don't know conversion. Thanks to you

Comment about this article, ask questions, or add new information about this topic:

Top Document: diabetes FAQ: treatment (part 3 of 5)
Previous Document: Alcohol and Diabetes
Next Document: Has anybody heard of frozen shoulder (adhesive capsulitis)?

Part1 - Part2 - Part3 - Part4 - Part5 - Single Page

[ Usenet FAQs | Web FAQs | Documents | RFC Index ]

Send corrections/additions to the FAQ Maintainer:

Last Update March 27 2014 @ 02:11 PM