VapoMeter® Skin Barrier and Diabetes: Measuring TEWL to Protect Skin and Prevent Complications
- Emma Danciu
- 2 days ago
- 8 min read
The History of Diabetes: From Ancient Times to Modern Medicine
Diabetes is a chronic condition affecting millions worldwide. Understanding its history provides insight into medical advancements and the ongoing fight against this disease. From early observations in ancient civilizations to modern treatments, the story of diabetes shows how science has transformed lives.
Diabetes has been recognized for over 3,000 years. Ancient Egyptians described symptoms such as excessive urination, thirst, and weight loss. The term “diabetes” comes from the Greek word “siphon”, highlighting the frequent urination characteristic of the disease.
Later, physicians added “mellitus”, meaning sweet, after discovering that urine from diabetics attracted ants due to its sugar content. These early observations laid the groundwork for understanding diabetes as a distinct medical condition.
For centuries, diabetes was poorly understood. Treatments were limited to diets and herbal remedies. In 1889, scientists Oskar Minkowski and Joseph von Mering linked the pancreas to diabetes by showing that removing it from dogs caused high blood sugar and other diabetes-like symptoms.
This discovery established the pancreas as the key organ in regulating blood glucose, setting the stage for one of medicine’s greatest breakthroughs.
The Discovery of Insulin
A major milestone occurred in 1921, when Frederick Banting and Charles Best discovered insulin, with John Macleod and James Collip refining the treatment. By 1922, insulin therapy successfully managed Type 1 diabetes, transforming it from a fatal disease into a treatable condition.
Insulin remains essential for Type 1 diabetes management and continues to save millions of lives worldwide.
Modern Understanding of Diabetes
Today, diabetes is categorized into several types:
Type 1 Diabetes: Autoimmune disease, often diagnosed in children and young adults.
Type 2 Diabetes: Related to insulin resistance, lifestyle, and genetics; more common in adults.
Gestational Diabetes: Develops during pregnancy and requires careful monitoring.
Modern management includes insulin therapy, oral medications, healthy diet, exercise, and continuous glucose monitoring. Advances in technology continue to improve quality of life for people with diabetes.
Why the History of Diabetes Matters
The history of diabetes highlights the progress of medical science and the importance of education and prevention. While insulin revolutionized care, Type 2 diabetes remains a growing global health challenge, driven by lifestyle factors and obesity.
Early detection, healthy living, and patient education are key to preventing complications and improving outcomes.
From ancient Egypt to modern medicine, diabetes has been a condition that challenged doctors and scientists for centuries. Understanding its history helps us appreciate the advances in treatment, the importance of education, and the ongoing need for awareness and prevention.
Diabetes in the U.S.: Trends, Risk Factors, and Who Is Most Affected
Diabetes is a growing public health challenge in the United States, affecting millions of people across all age groups. Understanding its evolution, demographics, and risk factors is essential for prevention, early detection, and effective management.
Today, approximately 38.4 million Americans — or 11.6% of the U.S. population — live with diabetes, making it one of the most common chronic conditions in the country. Of these, about 29.7 million have been diagnosed, while roughly 8.7 million people (23% of those with diabetes) remain undiagnosed.
Over the past two decades, the prevalence of diabetes has steadily increased, rising from 10.3% in 2001 to 11.6% in 2021. In addition, nearly 1 in 3 U.S. adults — approximately 97.6 million people — have pre-diabetes, a condition that significantly increases the risk of developing type 2 diabetes if lifestyle changes or early interventions are not implemented.
Who Is Most Affected
The groups most affected by diabetes can be divided into three main categories: age, race and ethnicity, and socioeconomic factors.
Age
The risk of diabetes increases with age, with nearly 30% of adults aged 65 and older living with the condition.
Race and Ethnicity
American Indian/Alaska Native: ~13.6%
Non-Hispanic Black: ~12.1%
Hispanic: ~11.7%
Non-Hispanic Asian: ~9.1%
Non-Hispanic White: ~6.9%
Socioeconomic Factors
Lower income and education levels correlate with higher prevalence. Rural and underserved communities also face elevated risk.
Why Diabetes Affects Certain Populations
Diabetes affects certain populations more than others due to a combination of lifestyle, genetics, age, and access to healthcare.
Lifestyle factors: Obesity, sedentary habits, and poor diet increase risk, particularly for type 2 diabetes.
Genetics & ethnicity: Certain populations are more genetically predisposed.
Age-related changes: Insulin resistance and metabolic shifts make older adults more susceptible.
Healthcare access: Limited access to preventive care and education increases the likelihood of undiagnosed diabetes and complications.
The growing prevalence of diabetes in the U.S. has serious consequences for both individuals and society. People with diabetes face increased risks of serious health complications, including kidney disease, heart disease, vision loss, amputations, and nerve damage.
Beyond health impacts, diabetes imposes a massive economic burden, with annual direct and indirect costs reaching hundreds of billions of dollars due to medical care, lost productivity, and disability.
Many cases remain undiagnosed or pre-diabetes goes unrecognized, creating a “silent” population at risk for complications and highlighting the need for prevention, early detection, and equitable healthcare access.
This emphasizes the importance of screening and early intervention:this is where the VapoMeter® plays a crucial role. |
The VapoMeter® measures transepidermal water loss (TEWL) to objectively assess skin barrier function in people with diabetes.
Monitoring TEWL helps identify dryness, dehydration, and compromised skin integrity before complications develop, allowing for timely interventions that protect skin health and prevent infections or chronic wounds.
What Is the VapoMeter® and How It Helps Protect Skin in Diabetes
The VapoMeter® is a non-invasive device used to measure the amount of water that passively evaporates through the skin. TEWL is a key indicator of skin barrier function: when the skin barrier is compromised, more water escapes, signaling dryness, dehydration, or structural impairment.
People with diabetes often experience subtle skin changes before visible symptoms appear, due to:
Dryness and dehydration: Diabetes can reduce natural skin moisture and lipid content.
Microvascular changes: High blood glucose can damage small blood vessels, reducing nutrient supply to the skin.
Neuropathy: Reduced nerve function may impair sweat regulation, worsening dryness.
Delayed healing: Impaired collagen and immune response slow recovery from micro-injuries.
These factors make early detection of skin barrier compromise critical, even before wounds or infections occur.
How the Measurement Works |
Probe Placement: The device has a small, closed-chamber probe that is gently placed on the skin, shielding measurements from ambient airflows and orientation effects — both of which are critical for fully accurate results. Read more about the decisive advantages of the closed-chamber.
Humidity Sensing: Inside the chamber, sensitive sensors detect the rate of transepidermal water loss from the skin.
TEWL Calculation: The VapoMeter® calculates TEWL in units of g/m²/h (grams per square meter per hour), providing a quantitative measure of skin barrier integrity. It offers a wide measurement range, accurate up to 200 g/m²h.
Data Interpretation: Higher TEWL readings indicate a weakened skin barrier, whereas lower readings reflect healthy, intact skin.
The process is fast, painless, and requires no consumables, making it suitable for repeated monitoring in clinical or research settings.
Benefits of TEWL Monitoring in Diabetes |
Using the VapoMeter® provides multiple advantages for diabetic skin care:
Early Detection: Identifies skin barrier impairment before dryness, cracks, or ulcers develop.
Personalized Treatment: Helps clinicians adjust moisturizers, barrier creams, and skincare routines based on objective readings.
Tracking Progress: Allows ongoing monitoring to evaluate treatment effectiveness and skin health over time.
Preventing Complications: Early intervention reduces the risk of infections, chronic wounds, and diabetic foot ulcers.
Patient Education: TEWL readings can guide patients on proper hydration, skin care, and blood sugar management.
VapoMeter®: Wound healing and TEWL
Skin barrier monitoring during treatment with 2 types of skin
protective agents used on skin surrounding chronic wounds, N = 40
TEWL in pressure ulcer group, N = 20
TEWL in venous leg ulcer group, N = 20
DiniV, SalibraF, BrilliC and RomanelliM
Instrumental evaluation of the protective effects of a barrier film on surrounding skin in chronic wounds.
Wounds2008;20(9):254-257.
If your patients have diabetes, consider TEWL monitoring with the VapoMeter® as part of a proactive skin health strategy. Early detection can prevent serious complications and protect skin integrity. |
Why a Closed Chamber Matters |
1. Prevents Airflow Interference
In an open-chamber device, external air currents can alter the evaporation rate from the skin, leading to inconsistent or inaccurate TEWL readings.
The closed-chamber isolates the skin surface from environmental airflow, ensuring that the measurement reflects true skin water loss, not external conditions.
2. Stabilizes Humidity Levels
The closed chamber allows the device to measure the increasing humidity inside the chamber over time.
By monitoring how quickly water vapor accumulates in the sealed environment, the VapoMeter® can calculate precise TEWL values.
3. Improves Reproducibility and Comparability
Because the closed chamber standardizes measurement conditions, readings can be compared over time or between patients.
This is especially important in diabetes care, where small changes in skin barrier function can indicate early complications.
4. Enhances Sensitivity for Early Detection
Subtle impairments in the skin barrier, such as those caused by diabetes-related dryness or microvascular changes, may not be detectable with less precise methods.
The closed-chamber design allows clinicians to detect early skin barrier compromise, enabling proactive intervention before visible damage occurs.
VapoMeter® vs. Laboratory scales and open chamber devices at different evaporation levels.
Conclusion:
Open chamber devices underestimate high evaporation values.
Diabetes affects the body physically by increasing water loss through urine, causing dehydration, and damaging blood vessels and nerves. The skin is particularly vulnerable, losing water more rapidly and becoming prone to dryness, cracks, and delayed healing. Tools like TEWL measurement with the VapoMeter® can detect these changes early, helping protect skin integrity and overall health.
So, for people living with diabetes, healthy skin is critical to prevent complications and maintain overall well-being. The VapoMeter® offers a simple, effective way to measure TEWL, detect early skin changes, and guide personalized care.
By incorporating TEWL monitoring into routine diabetes management, clinicians can protect skin integrity, prevent infections, and improve quality of life.
Early detection matters in diabetes:
Measure TEWL accurately with the VapoMeter®.
Discover Delfin’s full range of skin research Instruments at Skinlabs and see how advanced measurement tools can elevate your next research. |
PUBLICATIONS |
PITZER SENIOR THESES
Jachung, Namlhun, "Exploring the Impact of Diabetes on Feet: Analysis of Foot Ulcers with a Focus on Eczema-Related Considerations" (2024). Pitzer Senior Theses. 183.
KARGER
Rawlings E. Lyle, Mirabel E. Dafinone, Pallas Lim, Anuj Budhiraja, Alisha Mehta, Sara E. Dahle, Roslyn Rivkah Isseroff; Healing Diabetic Foot Ulcers with Topical Timolol Improves Healed Epithelial Integrity. Skin Pharmacol Physiol 5 August 2025; 38 (3) : 92-102.
MDPI
Abusharha, A.; El-Hiti, G.A.; Alsubaie, M.H.; Munshi, A.F.; Alnasif, A.R.; Fagehi, R.; Alanazi, M.A.; Masmali, A.M. Evaluation of Tear Evaporation Rate in Patients with Diabetes Using a Hand-Held Evaporimeter. Healthcare 2022, 10, 104.
MDPI
Byambajav, M>; Collier, A.; Shu, X.; Hagan, S. Tear Fluid Biomarkers and Quality of Life in People with Type 2 Diabetes and Dry eye Disease. Metabolites 2023, 13, 733.
Biomolecules & Therapeutics
Kim M, Jeong H, Lee B, Cho Y, Yoon WK, Cho A, Kwon G, Nam KT, Ha H, Lim KM. Enrichment of Short-Chain Ceramides and Free Fatty Acids in the Skin Epidermis, Liver, and Kidneys of db/db Mice, a Type 2 Diabetes Mellitus Model. Biomol Ther (Seoul). 2019 Sep 1;27(5):457-465.
doi: 10.4062/biomolther.2018.214. PMID: 30739427; PMCID: PMC6720538.
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