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The deficiency of vitamin B12 is found to cause the skin darkening

The following represents key Coding Clinic positions relevant to diabetes mellitus as of the most recent published guidance (4Q 2023 through 2025): Long-Term Insulin Use with Type 2 Diabetes Coding Clinic has consistently affirmed that when a Type 2 diabetic patient uses long-term insulin, coders must assign Z79.4 (long-term current use of insulin) as an additional code

Chong W, Shastri M, Eri R (2017) Endoplasmic reticulum stress and oxidative stress: a vicious nexus implicated in bowel disease pathophysiology

You may also want to consider long-acting reversible contraception like the implant or coil