Can Sweating Be a Symptom of Diabetes?

Diabetes is an endocrine disorder, which means that it impacts many different systems in our body.

One of the ways diabetes can affect the body is by overstimulating the sweat glands. Because of this, it's harder to maintain a steady internal body temperature.

Extreme fluctuations in blood sugar can also affect perspiration, leading to hyperhidrosis (excessive sweating) or anhidrosis (lack of sweating).

This article discusses the link between diabetes and sweating, how to manage this symptom, and when to call your healthcare provider.

What Is Excessive Sweating?

Excessive sweating is a condition in which people sweat more than normal, often without any apparent reasons. People who sweat excessively may even sweat in cooler temperatures. The condition is often the result of overactive sweat glands.

Excessive sweating may be triggered by situational factors (exercise, general movement, nervousness, etc.) or occur without any obvious cause. While it's not life-threatening, the condition can significantly impact quality of life and emotional health.

Is Excessive Sweating A Symptom of Diabetes?

Excessive sweating is commonly experienced in those with diabetes and may signal a need for tighter glucose management. Conversely, anhidrosis or reduced or absent sweating is less common but may be experienced in the feet or legs of people with diabetic neuropathy.

Research shows that up to 84% of people with diabetes experience sweating when they’re hypoglycemic, with the most common sweat area being behind the neck.

Fortunately sweating in those with diabetes is often due to mildly low blood sugar episodes that usually go away shortly after you take in some sugar.

There are different types of sweating issues that may arise due to diabetes:

• Hyperhidrosis
• Gustatory sweating
• Night sweats
• Hypoglycemia

Hyperhidrosis

Adrenaline causes excessive sweating, or hyperhidrosis, as part of a counter‐regulatory hormonal response to the low glucose.

The body wants to stay within very narrow hormonal ranges to maintain homeostasis (the body's need to reach and maintain a certain state of equilibrium). Whenever this is thrown off, as is the case in diabetes, thermoregulation is disrupted and hyperhidrosis may occur.

Gustatory Sweating

Gustatory sweating is a common manifestation of diabetes mellitus that is not often recognized.  The unusual phenomenon is characterized by excessive sweating of the face, scalp, and neck after ingestion of food and/or drink.

Gustatory sweating is seen in long-standing diabetes and is associated with nephropathy, peripheral neuropathy, and other conditions that disrupt our autonomic system. Profuse head and neck sweating after eating are usually all that is needed to make a clinical diagnosis.

Night Sweats

At night, the body uses energy from the carbohydrates you eat during the day to repair and restore itself. If you have not consumed enough carbohydrates, the body's thermoregulatory system may go awry.

The key to avoiding night sweats is to monitor your symptoms prior to going to bed. If caught early, your low blood sugars may be corrected quickly by consuming a simple carbohydrate like crackers or a piece of fruit. The amount you sweat is often directly proportional to your blood sugar levels, which means the greater length of time your blood sugar is low, the more you will sweat.

Hypoglycemia

Hypoglycemia or low blood sugar is a common cause of sweating, esp. Adrenaline is produced in response to declining blood sugar levels, which results in the narrowing of blood vessels and the activation of sweat glands. 

Low blood sugar can happen for a number of reasons, including:

• Taking too much insulin
• Not consuming enough carbohydrates
• Skipping a meal or snack
• Excessive exercise (without adjusting your medication)
• Taking too much of an insulin-producing medication
• Drinking alcohol

Automatic Neuropathy

Automatic neuropathy is damage to nerves that control your body's organs. It can be caused by prolonged and untreated high blood glucose. One of the many areas of the body affected by automatic neuropathy is the sweat glands.

Depending upon how severe the nerve damage has become, automatic neuropathy may cause the sweat glands to stop functioning in some parts of the body, while causing them to become overactive in other areas.

Sweating caused by automatic neuropathy is particularly prominent at night or while eating.

Treatments and Management of Excessive Sweating

Treatment of excessive sweating depends on the severity, cause, and whether the symptoms are local or widespread.

Local treatments include:

• Aluminum chloride 15% to 25% or antiperspirants
• Tap water iontophoresis for sweating on the hands or feet
• Glycopyrrolate for gustatory sweating
• Botulinum toxin (Botox) injections

Oftentimes, diabetes-induced sweating results in generalized sweating around the body. Systemic treatments to control sweating include:

• Anticholinergic drugs (e.g., methanthelinium bromide)
• Tricyclic antidepressants (e.g., amitriptyline)
• Beta-blockers
• Calcium channel blockers (e.g., diltiazem)

Surgery may be considered for more severe symptoms. These include:

• Endoscopic thoracic sympathectomy
• Axillary curettage, liposuction for axillary hyperhidrosis
  

Lifestyle Changes

If you have excessive sweating caused by diabetes, it may impact your relationships, confidence, and ability to carry out daily activities. Fortunately, there are ways to manage your symptoms and ease sweating-induced anxiety.

Carrying antiperspirant and a change of clothes and taking an extra shower per day may be small—albeit sometimes difficult—changes that you can make to help cope with your symptoms.

You may also want to consider keeping a sweat journal that tracks common triggers of your perspiration. Common triggers include heat, feeling anxious, and certain foods, especially those that contain:

• Monosodium glutamate (MSG)
• Caffeine (chocolate, coffee, tea)
• Spices such as curry or cumin
• Alcohol

When to See Your Healthcare Provider

Excessive sweating can be very uncomfortable and disruptive to your everyday life. You can work with your healthcare provider to diminish frequency and severity, and should seek immediate medical care if your sweating is accompanied by:

• Chest pains
• Lightheadedness
• Trouble breathing
• Severe anxiety

Your healthcare provider will be able to help address the immediate and long-term impact of this condition.

Seek immediate medical attention if you experience the following symptoms:

• High fever, particularly a temperature of 104 F or higher
• Chills
• Chest pain
• Lightheadedness
• Confusion
• Nausea or vomiting
  

Summary

Excessive sweating from diabetes is usually caused by low blood sugar but can also be caused by nerve damage. Some of these causes may require clinical intervention from your healthcare provider. By managing your blood glucose, and implementing other lifestyle changes, you may be able to control your diabetes-related sweating and improve your quality of life.

A Word From Verywell

Excessive sweating in diabetes is a common symptom that is often overlooked. If you are sweating during the day, after eating, or at night, you may want to take a closer look at your blood sugar levels and make changes to your treatment regimen. Fortunately, managing hypoglycemia leads to a vast improvement of your sweating.

Getting your sweating under control may not be easy at first, but addressing the issue head-on will help to increase your quality of life.