Diabetic Blisters Explained

                                     

The scientific term for this condition is Bullosis Diabeticorum. It is also known by the terms bullous disease of diabetes and diabetic bullae. (1, 2)  This is a very rare condition that is unique to people with diabetes. Statistics of occurrence are estimated at approximately 0.5 percent of people with diabetes. (3) 

What are diabetic blisters?

These are non-inflammatory, painless blisters that may appear suddenly and look like one had a burn blister but no burn, previous injury or

trauma took place. They are described in the literature as usually found on acral skin surfaces of the body.  (4, 5) 
Acral is defined as affecting peripheral parts of the body such as ones limbs, fingers or ears. (6) These blisters are most often reported on the lower legs and feet but they have been noted on the fingers, hands and arms. The blister contains a clear fluid and usually contain eosinophils which are a type of white blood cells. The cause of these blisters is currently unknown. (4, 5) 
The size of the blisters range from a few millimeters to several centimeters (over one inch diameter).  The literature is not consistent as to if a higher blood glucose level correlates with this disease. One published article reports no relationship could be identified. (4)  In another report presents a case study of an elderly man who had many reoccurring diabetic blisters over an 11 year period. Statistics on his blood glucose level showed that blisters were more likely to be formed when his blood glucose levels were high. (2) 

Who are more likely to develop diabetic blisters?

Men are twice as likely to have diabetic blisters as women. (1)  When they appear, the person is likely to have had diabetes for a long time or a history of neuropathy. (3)  Even though they most often occur with long standing diabetes, they also have been reported in patients with newly diagnosed type 2 diabetes. This type of blister has also been related to ultra violet therapy.  Diabetic blisters have been reported in people between the ages of 17 and 84 years. (1) 

What should one do if a blister develops?

Call your doctor to see how you should proceed. The diagnosis is based on exclusion. (3)  Please be careful when these develop as secondary infections may require a culture taken with subsequent antibiotic therapy as needed.  On rare occasions it can lead to ulceration and amputation due to infection. Many times no specific treatment is given but on occasion the clinician may elect to aspirate the fluid from the blister to prevent it from rupturing. (1) It is not recommended one perform this themselves, as the risk of infection can be high  Healing can take up to 6 weeks and is spontaneous but be mindful that the blisters may reoccur in the same or different locations. (1, 3)
Usually the blisters when healed do not result in scarring.  An article published by the American Diabetes Association on skin conditions in diabetes concluded that the only treatment for diabetic blisters is to bring blood glucose levels under control. (5) 

Advice on Diabetic Blisters from a Certified Educator:

It is important to call your physician and get checked out if you develop blisters when you have diabetes. The blisters in this article are not the only kind of blisters a person can develop. Proper treatment depends on an accurate diagnosis. As this article was written based on a special request, please do not hesitate to ask for articles to be written about topics you have questions about. We at DiabetesCare.net are not physicians and cannot recommend specific medical treatments but we can provide useful information and help explain topics relating to your health.
Please read my other blog on Cellulitis and Diabetes for additional information on cellulitis complications when you have diabetes.

1,2,3,4,5 
6 - Acral." The American Heritage® Stedman's Medical Dictionary. Houghton Mifflin Company. 8 Aug. 2014.

By Clara Schneider MS, RD, RN, CDE, LDN