A Review on Metabolic Dysregulation & Cutaneous Pigmentation: Elucidating the Role of Diabetes Mellitus in Melanogenic Pathways

Authors

  • Vaishali Thakur Research Scholar, Department of Zoology, Jata Shankar Trivedi Post Graduate College, Balaghat, Madhya Pradesh, India Author
  • Durgesh Agase Assistant Professor, Department of Zoology, Jata Shankar Trivedi Post Graduate College, Balaghat, Madhya Pradesh, India Author
  • Harsh Tiwari Department of Zoology, Biospark Research Institute & Laboratories Private Limited Balaghat, Madhya Pradesh, India Author
  • Karan Singh Saini Assistant Professor, Department of Zoology, PMCOE, Government Post Graduate College, Sheopur, Madhya Pradesh, India Author
  • Jyoti Thakre Research Scholar, Department of Zoology, Jata Shankar Trivedi Post Graduate College, Balaghat, Madhya Pradesh, India Author

DOI:

https://doi.org/10.71393/2ehfxb88

Keywords:

Keywords: Diabetes mellitus, Voglibose, Metformin, Pigmentation disorder, Melanin synthesis

Abstract

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from inadequate insulin secretion, impaired insulin action, or both. Its global burden has increased substantially, with diabetes-related mortality rising by approximately 70% between 2000 and 2019. Diagnosis primarily relies on glycated hemoglobin (HbA1c) and fasting blood glucose (FBG). Diabetes also produces characteristic cutaneous manifestations, including diabetic dermopathy and acanthosis nigricans, which may provide clinically useful indicators of metabolic dysfunction. Emerging evidence suggests a relationship between melanin metabolism and diabetes, with altered pigmentation and reduced melanin reported particularly in type 1 diabetes.

Aim & Objective: To explore the association between diabetes mellitus, cutaneous manifestations, and melanin metabolism, and to assess the potential therapeutic relevance of antidiabetic drugs in pigmentation disorders.

Material & Method: Relevant published literature was reviewed to evaluate the relationship between diabetes, glycemic parameters, skin manifestations, melanin production, and the effects of commonly used antidiabetic medications, particularly metformin and voglibose, on melanogenesis.

Result: Diabetes was associated with several characteristic skin changes, including diabetic dermopathy and acanthosis nigricans. Alterations in melanin production have also been reported, particularly reduced melanin levels in type 1 diabetes. Metformin and voglibose demonstrated potential inhibitory effects on melanin synthesis, suggesting possible applications beyond glycemic control.

Conclusion: Cutaneous manifestations may provide useful clinical clues to underlying diabetes and metabolic abnormalities. The emerging relationship between melanin metabolism and diabetes highlights potential opportunities for integrating dermatological assessment into diabetes management and exploring antidiabetic agents as novel therapeutic approaches for pigmentation disorders.

REFERENCES

  1. Ben Sahra I, Le Marchand-Brustel Y, Tanti JF, et al. Metformin in cancer therapy: a new perspective for an old antidiabetic drug? Mol Cancer Ther. 2010;9:1092-1099. https://doi.org/10.1158/1535-7163.mct-09-1186
  2. Binkley GW. Dermopathy in the diabetic syndrome. Arch Dermatol. 1965;92(6):625-634. https://doi.org/10.1001/archderm.1965.01600180017003
  3. Brady MF, et al. Acanthosis nigricans. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK431057
  4. Danowski TS, Sabeh G, Sarver ME, et al. Shin spots and diabetes mellitus. Am J Med Sci. 1966;251(5):570-575. https://doi.org/10.1097/00000441-196605000-00011
  5. Diabetic Medicine. Diabet Med. 2016;34(7):925-933. https://doi.org/10.1111/dme.13297.
  6. Edwards E, Yosipovitch G. Skin manifestations of diabetes mellitus. In: Endotext. South Dartmouth (MA): MDText.com, Inc.; 2025:1-80. https://www.ncbi.nlm.nih.gov/books/NBK481900/
  7. Fatoki TH, Ibraheem O, Adeseko CJ, Afolabi BL, Momodu DU, Sanni DM, et al. Melanogenesis, its regulatory process, and insights on biomedical, biotechnological, and pharmacological potentials of melanin as antiviral biochemical. Biointerface Res Appl Chem. 2021;11(4):11969-11984. https://doi.org/10.33263/briac114.1196911984
  8. Fu C, Chen J, Lu J, Yi L, Tong X, Kang L, et al. Roles of inflammation factors in melanogenesis (Review). Mol Med Rep. 2020;21(3):1421-1430.
  9. Harris R, Reddy BY. Acanthosis nigricans. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK431057
  10. Skin conditions and type 2 diabetes. 2023. https://www.healthline.com/health/type-2-diabetes/skin-problems
  11. Hu D, Wu Y, He D, Rong J, Sun M, Yu Z, et al. Salivary biomarkers in diabetes mellitus diagnostics: a bibliometric analysis. Medicine (Baltimore). 2025;104(32):e43760. https://doi.org/10.1097/md.0000000000043760
  12. Kim HM, Hyun CG. Drug repurposing of voglibose, a diabetes medication for skin health. Pharmaceuticals (Basel). 2025;18(2):1-18. https://doi.org/10.3390/ph18020224
  13. Kim HR, Lee SH, Noh EM, Oh BJ, Kim SY, Park MH. Anti-melanogenic effect of Moju through inhibition of tyrosinase activity. Mol Cell Toxicol. 2023;20(2):243-250. https://doi.org/10.1007/s13273-022-00329-8
  14. Edwards E, Yosipovitch G. Skin manifestations of diabetes mellitus. In: Feingold KR, Adler RA, Ahmed SF, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2025. https://www.ncbi.nlm.nih.gov/books/NBK481900/
  15. Lause M, Kamboj A, Kumar P. Ophthalmic manifestations of endocrine disorders—endocrinology and the eye. Adv Ophthalmol Vis Syst. 2017;6(4):286–299. https://doi.org/10.21037/tp.2017.09.13
  16. Legiawati L. The role of oxidative stress, inflammation, and advanced glycation end product in skin manifestations of diabetes mellitus. Curr Drug Targets. 2022;18(3):87–92. https://doi.org/10.2174/1573399817666210920102318
  17. Lehraiki A, Abbe P, Cerezo M, Rouaud F, Regazzetti C, Chignon-Sicard B, et al. Inhibition of melanogenesis by the antidiabetic metformin. J Invest Dermatol. 2014:2589–2597. https://doi.org/10.1038/jid.2014.202
  18. Ly L, Vo KL, Cruel AC, Shubrook JH. Dermatological manifestations of diabetes mellitus and its complications. Diabetology. 2025;6(3):1-18. https://doi.org/10.3390/diabetology6030018
  19. Lorente Prieto E. Cosmetic topical use of vitamin C. In: Ascorbic acid: biochemistry and functions. London: IntechOpen; 2023:1–21. https://doi.org/10.5772/intechopen.109644
  20. Mackiewicz-Wysocka M, Araszkiewicz A, Schlaffke J, Kuczynski S, Micek I, Zozulinska-Ziolkiewicz D. Lower melanin content in the skin of type 1 diabetic patients and the risk of microangiopathy. Exp Clin Endocrinol Diabetes. 2014;122(4):231-235. https://doi.org/10.1055/s-0034-1367003
  21. Melin H. An atrophic circumscribed skin lesion in the lower extremities of diabetics. Acta Med Scand. 1964;176(Suppl 423):9-75.
  22. Montero I, Requena C, Traves V, Garcia-Casado Z, Kumar R, Nagore E. Age-related characteristics of cutaneous melanoma in a Spanish Mediterranean population. Int J Dermatol. 2015;54:778-784. https://doi.org/10.1111/ijd.12496
  23. Moraes VR, Melo MO, Maia Campos PMBG. Evaluation of morphological and structural skin alterations in diabetic subjects. Life (Basel). 2023;13(2):1-13.
  24. Morgan AJ, Schwartz RA. Diabetic dermopathy: a subtle sign with grave implications. J Am Acad Dermatol. 2008;58(3):447-451. https://doi.org/10.1016/j.jaad.2007.11.013
  25. Naik PP, Farrukh SN. Clinical significance of diabetic dermatopathy. Diabetes Metab Syndr Obes. 2020;13:4823-4827. https://doi.org/10.2147/dmso.s286887
  26. Ngo BT, Hayes KD, DiMiao DJ, et al. Manifestations of cutaneous diabetic microangiopathy. Am J Clin Dermatol. 2005;6(4):225-237.
  27. Orlow I, Satagopan JM, Berwick M, et al. Genetic factors associated with naevus count and dermoscopic patterns. Br J Dermatol. 2014;172:1081-1089.
  28. Pollak M. Metformin and other biguanides in oncology: advancing the research agenda. Cancer Prev Res (Phila). 2010;3:1060-1065. https://doi.org/10.1158/1940-6207.capr-10-0175
  29. Poonja PP, Kiss F. Pathophysiology of the skin in type 1 and type 2 diabetes and emerging therapeutic opportunities. Int J Diabetes Clin Res. 2024;11:1-9. https://doi.org/10.23937/2377-3634/1410182
  30. Rudnicka L, Schwartz RA, Borkowski A. Dermatological manifestations of diabetes mellitus. Int J Mol Sci. 2022;23(19):6-11.
  31. Shemer A, Begman R, Linn S, Kantor Y, Friedman-Birnbaum R. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998;37(2):113-115. https://doi.org/10.1046/j.1365-4362.1998.00273.x
  32. Sil A, Poddar S, Das A, Ray D. Metabolic syndrome and pigmentation: a review of the connecting link. Clin Exp Dermatol. 2025;50(10):1953-1962. https://doi.org/10.1093/ced/llaf218
  33. Singh NK, Verma AK, Gupta JK. Understanding mechanisms and key factors influencing melanogenesis for the management of melasma: an updated review. Curr Pharm Biotechnol. 2025;26(10):1564-1581. https://doi.org/10.2174/0113892010301957240424110023
  34. Sultan F, Basu R, Murthy D, Kochar M, Attri KS, Aggarwal A, et al. Temporal analysis of melanogenesis identifies fatty acid metabolism as key skin pigment regulator. PLoS Biol. 2022;20(5):1-32. https://doi.org/10.1101/2021.04.06.438588
  35. Svoboda SA, Shields BE. Cutaneous manifestations of nutritional excess: pathophysiologic effects of hyperglycemia and hyperinsulinemia on the skin. Cutis. 2021;107(2):74–78. https://doi.org/10.12788/cutis.0173
  36. Tomic T, Botton T, Cerezo M, et al. Metformin inhibits melanoma development through autophagy and apoptosis mechanisms. Cell Death Dis. 2011;2:1-10. https://doi.org/10.1038/cddis.2011.86
  37. Videira IFS, Moura DFL, Magina S. Mechanisms regulating melanogenesis. An Bras Dermatol. 2013;88(1):76-83. https://doi.org/10.1590/s0365-05962013000100009
  38. Watts CG, Dieng M, Morton RL, Mann GJ, Menzies SW, Cust AE. Clinical practice guidelines for melanoma risk. Br J Dermatol. 2015;172:33-47.
  39. Woodard J, Platanias LC. AMP-activated kinase signals in melanoma cell growth. Biochem Biophys Res Commun. 2010;398:135-139. https://doi.org/10.1111/bjd.13403
  40. Yoon JH, Jang WY, Park SH, Kim HG, Shim YY, Reaney MJT, et al. Anti-melanogenesis effects of a cyclic peptide derived from flaxseed. Int J Mol Sci. 2023;24(1):1-18. https://doi.org/10.3390/ijms24010536

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Published

2026-10-03

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A Review on Metabolic Dysregulation & Cutaneous Pigmentation: Elucidating the Role of Diabetes Mellitus in Melanogenic Pathways. (2026). Journal of Biology, Medicine & BioMedicine , 1, 33-38. https://doi.org/10.71393/2ehfxb88