Does Diabetes Make You Bruise Easily?

“A bruise should start out as a purple patch and then fade the way we all know, to that dark color and then turn into that yellow, then that brown, and then generally be gone,” says Ronda Farah, MD, a board-certificated dermatologist and an associate professor at the University of Minnesota Medical School in Minneapolis.

On the other hand, sometimes a bruise — or the underlying cause of a bruise, such as a broken bone — will require medical attention.

Diabetes can make people more prone to easy or unexpected bruising in several ways:

• High blood sugar can cause blood vessel damage
• Needles and lancets can cause injury at the puncture site
• Peripheral neuropathy can damage nerves, dulling your ability to notice injury
• Diabetes impacts collagen production, which thins the skin

People with diabetes may be slower to heal from cuts, too. “People with diabetes can experience delayed wound healing for several reasons,” says Joshua J. Neumiller, PharmD, CDCES, the president-elect of healthcare and education for the American Diabetes Association. “If people have hyperglycemia (high blood glucose), high blood pressure, or high cholesterol for a long period of time, this can lead to blood vessel damage and poor circulation (blood flow).”

“In the case of people who bruise due to injection of medications or through glucose monitoring (with fingersticks or CGM), it is important to use new needles and lancets each time and rotate injection and testing sites,” says Dr. Neumiller.

“Neuropathy is nerve damage that leads to changes in the ability to feel one's body parts,” says Deena Adimoolam, MD, an endocrinologist for Mount Sinai Health System in New York City. “Due to this loss of sensation, people with neuropathy may not realize they have injured their body part, which may lead to unexplained bruising.”

“When blood glucose is elevated, it can interact with collagen, leading to skin changes in people with diabetes,” says Neumiller.

• Older age: The risk of diabetes increases as we grow older, and the skin thins with time and offers blood vessels less protection.
• Certain medications: People with diabetes often have other health issues, such as coronary artery disease, peripheral arterial disease, or atrial fibrillation, that require blood thinners that increase the risk of bruising. Nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids used for other conditions also make people more prone to bruising.
• Family history: Some people inherit blood disorders that can cause them to bruise easily. Hemophilia is a rare condition in which a person bleeds excessively because their blood doesn’t clot properly. Von Willebrand disease and other platelet disorders can also contribute to bruising.
• Vitamin deficiencies: Vitamins C and K both play a role in maintaining healthy blood vessels.

• Keep the area elevated to reduce blood flow to the bruise and limit bleeding.
• Apply ice for a day or two to slow the blood flow and reduce swelling and pain.
• Use acetaminophen to help with pain relief and inflammation. NSAIDs and aspirin should be avoided.
• Wrap a light bandage around the bruise to reduce swelling.
• Use warm compresses after the bruise is more than two days old.

And for people with diabetes, blood sugar is always an important element of overall health. “Managing blood sugar leads to healthier blood vessels, which can allow for our blood cells to function normally and help wounds heal normally as well,” says Dr. Adimoolam.

• Unexplained or recurring bruising
• Bruises that won’t heal
• A lump forming at the bruise, which could be a hematoma, a closed wound where blood pools inside the body.

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• Abnormal bleeding
• Lack of pain relief after three days
• Swelling hasn’t gone down after three days

“If people experience bruising that is accompanied by other symptoms (such as severe swelling, fever, excessive pain), is recurrent and/or severe, or they are taking blood thinners, it is a good idea to seek medical advice and evaluation,” says Neumiller.

• High blood sugar levels caused by diabetes, which can impair blood circulation and wound healing, can cause people to bruise easily and heal slowly.
• Medical devices like syringes and continuous glucose monitors (CGMs) can cause bruising where they pierce the skin.
• Peripheral neuropathy can lead to a loss of sensation, making it more difficult to notice you’ve injured yourself, and unexplained bruising.
• Bruises are usually not considered serious, but in rare cases they may require medical attention. Let your healthcare provider know if you have bruises that develop mysteriously or that don’t seem to heal.