From healthcentral.com
Scientists took a close look at the connection between psoriasis and diabetes. The findings could change the way some healthcare is practised
High blood sugar may do more than coexist with psoriasis (PsO)—it might actually trigger flare-ups. That’s the key takeaway from a new study published in Clinical, Cosmetic and Investigational Dermatology, which found that hyperglycaemia (elevated blood sugar levels) is associated with worsening psoriasis symptoms, especially in people with severe disease.
“This is significant because it reinforces the idea that psoriasis is not just a skin-deep issue,” says Hannah Kopelman, D.O., a board-certified dermatologist and skincare podcast host in Boston who was not involved in the research. “It’s a systemic inflammatory disease that interacts with other metabolic conditions in complex ways.”
For years, researchers have known that people with psoriasis (PsO) tend to have elevated levels of inflammatory substances in their blood—raising their risk for metabolic syndrome, cardiac events, and diabetes. But this new research suggests a more active role for blood sugar: it may not only reflect disease severity but actually drive it. The bidirectional relationship could have profound implications for how we approach treatment strategies for the estimated 7.5 million Americans living with this chronic skin condition.
Blood Sugar’s Role in Predicting Psoriasis Flares
So, what did the research show? In a retrospective cohort study, scientists reviewed 15 years of medical data from 201 patients with plaque psoriasis treated at Ramathibodi Hospital in Bangkok, Thailand. Of those, 95 had severe psoriasis and 106 had mild disease. All participants also had either type 2 diabetes or prediabetes.
To examine the possible connection between long-term blood sugar levels and psoriasis flare-ups, the researchers analysed data from more than 1,700 follow-up visits between 2008 and 2022. Specifically, they looked at HbA1c levels—a measure of blood sugar control over time.
The findings revealed that patients with severe psoriasis who had an HbA1c of 7% or higher (indicating poorly controlled diabetes or prediabetes) were significantly more likely to experience flares. The study also identified alcohol consumption as a separate risk factor for flare-ups.
“In our study, we found that hyperglycemia (HbA1c ≥ 7%) and alcohol drinking status were independent prognostic factors for exacerbation in severe psoriasis patients with diabetes or prediabetes,” the researchers wrote. “We believe that diabetes surveillance may be necessary for all psoriasis patients, and strict glycaemic control may aid in managing severe psoriasis.”
A Call for Cross-Specialty Collaboration
The findings also underscore that rarely does a chronic disease—or its treatment—exist in isolation—the study links dermatology, endocrinology, and primary care as essential components in managing psoriasis.
“This research reminds us that everything is interconnected,” says Dr. Kopelman. “In the clinic, we may start emphasizing not just topical or biologic treatments but also the importance of metabolic health as part of the treatment plan for psoriasis.”
For patients struggling with both conditions, this study offers hope that better control of one condition may positively impact the other. This research gives us another tool in our toolkit, explains Dr. Kopelman. We now have stronger evidence to motivate patients to work on their blood sugar control as part of their comprehensive psoriasis management strategy.
While more research is needed to fully understand how high blood sugar influences psoriasis flares and treatment outcomes, the takeaway is clear: for people with severe psoriasis, managing blood sugar may be a meaningful part of reducing flare risk—and a reminder that whole-body health matters in skin disease management.
