Diabetes impacts many of the body’s systems because it’s an endocrine disorder. People with diabetes have trouble regulating their internal body temperature. As part of this, those with diabetes may face excessive sweating or they may not sweat enough.

Hyperhidrosis is a form of excessive sweating that can be a result of primary or secondary causes. Secondary hyperhidrosis is a form of excessive sweating which is caused by a separate condition, such as diabetes.

Anhidrosis is a lack of sweating. While anhidrosis and hyperhidrosis can both be caused by diabetes, hyperhidrosis is more commonly experienced. Anhidrosis is most commonly experienced in the extremities by those who have diabetic neuropathy. It occurs in moments of high or low blood sugars, and therefore, the presence of either of these conditions may signal that better diabetes management is needed.

Of all individuals with diabetes, approximately 84% experience sweating when they are experiencing low blood sugars. Most commonly, this occurs behind the neck. The sweating goes away when the blood sugar is back in normal range.

A Breakdown of Types of Sweating

Hyperhidrosis, as discussed, is often a result of the body’s response to low blood sugar. When the body experiences low blood sugar, it leads to an increased production of adrenaline, which leads to the narrowing of blood vessels, and activates the sweat glands.

Gustatory sweating is a specific form of sweating which occurs on the face, neck, and scalp after the consumption of food or drink. This type of sweating is often associated with diabetes, nephropathy, and peripheral neuropathy.

Finally, sweating at night is common in diabetes when enough carbohydrates have not been consumed during the day. When diabetes is adequately controlled during the day, night sweats are less common.

Diagnosis

Excessive sweating can be diagnosed clinically based on symptoms and presentation. Often, the culprit is hypoglycemia (low blood sugar) due to diabetes.

Patients often mention waking up with night sweats as one of the primary symptoms which led them to get checked out.

A dermatologist is a great person to book a consultation with if you think that you are facing excessive sweating.

Treatment

Excessive sweating can be treated locally or throughout the body as a whole. Local treatments that may be used are-

• Aluminum chloride
• Antiperspirants
• Glycopyrrolate (used for gustatory sweating)
• Tap water (used for palmar or plantar sweating
• Botox injections

Systemic treatments may include-

• Calcium channel blockers like diltiazem
• Beta-blockers
• Tricyclic antidepressants such as amitriptyline
• Anticholinergic therapies such as methathelinium bromide

For those with very severe symptoms, surgery may be suggested. Patients may undergo endoscopic thoracic sympathectomies or axillary curettage.

Other ways to improve sweating are to avoid triggers such as alcohol, spices, caffeine, MSG, anxiety, heat, and others. It can be helpful to track what your individual triggers are, as these can vary from person to person.

You can read more about the link between diabetes and excessive sweating here.