Does Diabetes Make You Sweat?

“Nerves help the body control our internal organs, including the sweat glands in our skin,” says Calvin Wu, MD, an endocrinologist with Tono Health in the San Francisco Bay area. “Unfortunately, high blood sugar with diabetes can, over time, damage the nerves responsible for transmitting these signals.”

“Some people may not sweat enough or at all, potentially all over, or only in certain parts of their bodies, because the nerves aren’t able to properly stimulate the sweat glands to release sweat on demand,” says Dr. Wu.

There are several types of problematic sweating that can be related to diabetes.

Hyperhidrosis is a health issue that causes the sweat glands to produce excessive moisture, sometimes for no apparent reason. It can happen if you’re overheated, exercising, stressed, nervous, or ate spicy or fatty food. Hyperhidrosis can be caused by diabetic neuropathy.

• Primary focal hyperhidrosis, which is a chronic skin condition that is caused by an inherited genetic mutation and usually starts in people younger than 25.
• Secondary generalized hyperhidrosis, which is caused by an underlying medical condition, like diabetes. Your doctor can run a test to determine the cause and identify ways to manage the condition.

The most common place to experience excessive sweating is on the palms of your hands, but it can also occur in your armpits, feet, forehead, cheeks, genitals, and lower back.

Beyond the lack of appropriate amounts of sweat, anhidrosis can also cause dizziness; red skin on the face, neck or chest; muscle cramps; and weakness. If you don’t sweat or barely do when temperatures are hot or you’re exercising intensely, discuss it with your doctor. You run the risk of developing heat exhaustion, heatstroke, and dehydration. In extreme cases, this could be life-threatening.

“There are many reasons why someone might experience night sweats,” says Wu. “In people who have diabetes and are taking insulin or certain glucose-lowering medications, a relatively common cause of night sweats can be low blood sugars overnight.”

A continuous glucose monitor (CGM) can sound a low blood sugar alarm as soon as your blood sugar starts to dip below normal levels, which could help prevent waking up in a cold sweat with significant hypoglycemia.

With gustatory sweating, you may have excess sweat on your cheeks, temples, or around your ear, and you may feel warmth in that area too. There’s currently no cure, but symptoms can be managed.

• Antiperspirants Prescription-strength antiperspirants that contain aluminum chloride can significantly reduce sweating by blocking sweat pores.
• Anticholinergics These pills, including oxybutynin and glycopyrrolate, block the chemicals that trigger sweating, but they can come with side effects including dry mouth, vision changes, and bladder issues.
• Botox Injections Most commonly thought of as an anti-wrinkle treatment, injections of Botox can provide temporary sweat relief by blocking the nerve signals that trigger sweating. Injections need to be recurring for long-term relief. Botox can cause a more than 80 percent decrease in sweating, and results are noticeable in 2 to 4 days. Full effects typically kick in within two weeks, and dryness can last for up to a year.

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• Topical Glycopyrronium This prescription medication comes in the form of pre-moistened, medicated cloths to wipe the underarm area.
• Iontophoresis This is an in-patient medical procedure that uses a small electrical current to temporarily reduce sweating, specifically for hands and feet. If treatment is successful, you can also buy a machine to use at home.

Diabetes-related excess sweating can also be managed or prevented with good diabetes management.

Monitor Your Glucose Levels

“The most important way to help reduce nerve damage that’s causing the excessive sweating is to understand your glucose levels, especially if they are staying above your personalized target range or goal,” says Shetal Desai Rautela, RDN, CDCES, a diabetes coach in private practice.

If your specific target range isn’t clear for you, book an appointment to see a diabetes healthcare professional. Good blood sugar control protects the nerves and can help prevent perspiration issues.

Adjust Your Diet

“Nutrition can help reduce the symptoms of excessive sweating, and is a cornerstone to lifestyle changes to keep glucose levels in check,” says Rautela.

Avoiding or limiting sugary foods is a must, but you don’t have to give them up entirely. “While occasional desserts to satisfy that sweet tooth is not a concern, frequent consumption can make it harder to manage glucose levels,” she says.

Exercise Regularly

Working out when your body’s sweat glands are already in overdrive may not seem appealing, but it is a great way to improve post-meal glucose levels, says Rautela.

“Try low-to-moderate intensity workouts, and it can be as simple as getting some steps in during the day to break up the work hours,” she says. “All and any steps taken aid in regulating the body temperature and improving glucose levels.”

Manage Stress Levels

To lighten your load, learn how to recognize your stressors and find ways to practice relaxation exercises, such as deep breathing and meditation, or talking to a friend. People with diabetes are significantly more likely to experience mental health conditions such as anxiety and depression. Sessions with a mental health provider should be considered a normal and important part of diabetes management.

• Nerve damage caused by chronically high blood sugar levels can cause excessive sweating, as well as other issues, such as not sweating enough or sweating irregularly.
• Low blood sugar, a side effect of glucose-lowering drugs like insulin, can also cause sweating, especially overnight.
• If excessive sweating is interfering with your quality of life, there are prescription treatments and medical procedures that can help.
• The best way to prevent the nerve damage that leads to irregular sweating is optimal blood sugar management through the proper use of diabetes medication and healthy lifestyle changes.

Additional reporting by Ginger Vieira.