When it comes to avoiding diabetes complications, two seemingly contradictory principles apply: Keep the skin hydrated, and keep it dry.

Let's start by explaining the importance of maintaining hydration. When blood glucose levels escalate, the skin becomes dehydrated and dry. This, in turn, may lead to irritation and cracking, common diabetes complications. And whenever skin is open and blood sugars are high, the risk of germs entering and infection occurring surges.

While hydrated skin indicates healthy skin, downright moist or sweaty skin does not. "Particularly for people who are overweight, moisture and fungus get into the folds of the skin," says diabetes educator Teresa Pearson, RN, CDE, president-elect for the American Association of Diabetes Educators. She recommends applying corn starch to skin folds so that it wicks moisture away.

Necrobiosis, a rare skin disorder associated with diabetes, can develop despite proper management of glucose levels. It can appear before the diagnosis of diabetes, but it usually occurs several years after.

The disorder causes small, raised, oval, dark red or brownish-yellow lesions with a thick shiny surface and sharply defined edges. They can be itchy and painful. If the spots break open, they require medical attention.

To date, treatment has proved fairly ineffective. In some cases, necrobiosis recedes without treatment. Although its development does not hinge on how well blood sugar levels are controlled, experts warn that high blood sugar may lead to secondary infections in the lesions.

The American Diabetes Association advises patients to minimize their risk of skin-related diabetes complications by following these guidelines:

-Keep skin clean and dry.
-Apply talcum powder to parts of the body where moisture is likely to develop.
-Avoid bathing or showering in extremely hot water.
-Prevent dry skin by using moisturizers and running a humidifier in your home during cold, dry months.
-Treat cuts immediately, avoiding use of harsh agents such as alcohol or iodine.
-See a dermatologist for unresolved skin problems.