This is the greatest epidemic of all. Obesity predisposes diabetes and diabetes underlies several skin conditions and especially skin infections. In the obese diabetic acanthosis nigricans is common.
Warning Diabetes often makes the treatment of other sys- temic conditions such as tuberculosis much more difficult. Whether a skin infection or a wound, damage to the skin of the obese is both more likely and repair is less effective. Diabetes has become a top priority for urgent intervention by all carers of the skin. 100% of diabetics have skin failure and in 70% it is manifest by skin lesions. Attention must be given to problems arising in the care of the overweight affecting the carer such as back injuries from lifting.
Action Carers of the skin can alert populations to the link between obesity and diabetes as well as making an early diagnosis. Care should prevent and certainly delay amputation. The 2012 Olympics have reminded the world that achieve- ment of the perfect body should begin at school with a full, dedicated sports programme. Malnutrition due to starvation affects all functions of the skin. 2 billion people are iron deficient, 255million children are vitamin A deficient and 1.6 billion people are iodine deficient.
Gardens grown for the personal procurement of fruit and vegetables are recommended. In Rwanda the focus is on linking an agricultural worker and a demonstration garden with a health centre and then providing from that resource help with home gardening. In India the focus is more on tribal knowledge and support for valuing and restoring the earth.