Sweating is a common response of the body to regulate the body temperature and keep it at a normal level. Going out in the sun will make the body surface hot and to cool it the person sweats. However, sometimes people tend to sweat at times when there is no reason for it. This is commonly seen in diabetics. Diabetes causes individuals at times to sweat either excessively or very little. This is because diabetes results in changes in the body that causes irregularities in body temperature causing sweating. These changes are usually hormonal; however, diabetics are also prone to cardiovascular illnesses which again can cause abnormal sweating.[2]
Stress can cause a lot of damage in diabetics and abnormal sweating is one of them. Abnormal sweating is generally a sign in diabetics that their sugars are not adequately controlled. Diabetics are prone to developing neuropathy. A sweat test conducted on diabetics with known neuropathy showed 48% of participants of the study had an abnormal sweat test.[1]
There was also anhidrosis or lack of sweating noted in about 16% of participants and all of these had significant autonomic neuropathy as a result of diabetes. Some diabetics with diabetic radiculopathy also showed abnormal sweat tests with some participants showing complete lack of sweat. This abnormality on the sweat test is quite a helpful tool in diagnosing neuropathies in diabetics. This article explains as to how diabetes can cause abnormal sweating.[1]
Can Abnormal Sweating Be Related To Diabetes?
Sweating occurs when the body attempts at regulating the overall body temperature. This happens when an individual is out in hot weather or while doing rigorous activities. An individual can also sweat when he or she is under severe stress. There are also certain medical conditions that cause abnormal sweating of which diabetes is one such condition.[2]
Diabetes causes an individual to either sweat too much or very little. This may lead to a variety of problems, especially when the affected individual is exposed to hot weather conditions. In such situations, if the individual sweats very little then the body temperature may rise abnormally. Similarly, if an individual sweats excessively in a relatively cold environment then this is also considered abnormal and a physician should be consulted for it.[2]
People with type-1 diabetes tend to sweat excessively on the upper half of the body and very little on the lower half of the body which again causes temperature differences causing complications. Abnormal sweating in diabetics is usually caused due to hypoglycemia which is a condition where an individual has very low blood sugar levels. This is usually caused by taking insulin dosages that are much higher than what has been recommended or advised. This results in the blood sugar spiraling downwards. It may also occur if an individual overdoes an exercise routine or does not eat enough food.[2]
The reason behind hypoglycemia causing abnormal sweating is that this condition affects how the autonomic nervous system functions. The primary function of the autonomic nervous system is to regulate involuntary activities like digestion and sweating. If the autonomic nervous system does not function the way it should it leads to abnormal sweating.[2]
Another reason given for abnormal sweating due to hypoglycemia is that this condition triggers the release of the stress hormone epinephrine. A sudden increase in the levels of epinephrine or adrenaline causes abnormal sweating. Hypoglycemia requires immediate treatment as it can lead to serious complications and thus an individual who has an episode of hypoglycemia needs to go to the emergency room immediately for treatment.[2]
At homes, till the time the emergency services arrive the patient can be given a sugar candy or some sweetener to increase sugar levels in the body. Damage to the nerves which is a common occurrence in diabetics also causes abnormal sweating. Additionally, if the blood sugars are extremely high for prolonged periods of time then it may also result in the individual having abnormal sweating due to nerve damage. This condition is referred to as diabetic neuropathy.[2]
Studies suggest that more than 50% of people with diabetes have some form of nerve damage. If the nerves that control the sweat glands get affected then the communication between these glands and the brain becomes disrupted causing abnormal sweating. This damage results in the individual sweating abnormally even while doing minimal physical activity or just sleeping. The individual may also start sweating in a relatively cold place. If exposed to certain stressful situations then also that individual may start sweating abnormally.[2]
Some people with diabetes experience a rare form of sweating known as gustatory sweating. In this form, the individual will usually have abnormal sweating in the face, scalp, and neck. It is usually caused due to nerve damage as a result of diabetes. Individuals with a known diagnosis of diabetic neuropathy tend to get gustatory sweating more than others. The sweating becomes more pronounced while eating even when the individual is having only a bland diet.[2]
In some cases, just the thought of having a meal will cause abnormal gustatory sweating. The primary areas where gustatory sweating occurs are forehead, cheeks, scalp, lips, and at times the chest and neck.[2]
Some diabetics also have another condition called anhidrosis where there is complete lack of sweating. This leads to the body finding it tough to stay cool when exposed to a hot environment. This also is mainly caused due to damage to the nerves responsible for sweating as a result of diabetes. Anhidrosis normally occurs when the nerves are not able to signal the brain to sweat even when sweat is required to cool the body.[2]
Research suggests that individuals with diabetes type-1 sweat more on the upper half of the body and less in the lower half. This in turn leads to complete lack of sweating in some individuals. People with anhidrosis due to diabetes also tend to have problems with adequate blood flow from the heart to different parts of the body. This also results in the body getting heated. The science behind it is normal blood flow under the skin aids in keeping the body cool. If the blood flow gets affected then overheating of the body occurs.[2]
Treatment of Abnormal Sweating in Diabetics
There are numerous ways that abnormal sweating due to diabetes can be treated or even in some cases prevented. The physician may prescribe antiperspirants to control the sweating. These medications contain Aluminium chloride which block the sweat pores and prevent sweat from coming to the skin surface. These medications however come with a side effect profile of skin irritation and should be used wisely as directed by the physician.[2]
Nerve-blocking medications are yet another way to treat abnormal sweating in diabetics. Anticholinergics are the most preferred medications used for this purpose. The function of this medication is to block acetylcholine which is a chemical responsible for causing sweat. This medication comes with a side effect profile of bladder problems, vision disturbances, and dry mouth and hence caution should be maintained while using this medication.[2]
Botox Injections are also quite effective in treating abnormal sweating in diabetes. These injections work by blocking nerve signals that cause sweating. This form of treatment does not have side effect; however, some people may experience muscle weakness and soreness at the injection site for a few days.[2]
Other treatment modalities that can be used for treating abnormal sweating in diabetes include use of antidepressants and electrotherapy which has shown some promise and effectiveness in dealing with abnormal sweating in people with diabetes.[2]
In conclusion, sweating is a mechanism through which the body regulates the temperature and keeps it cool when exposed to hot environment. While excessive or abnormal sweating can be socially embarrassing lack of it is quite serious and needs to be treated. Abnormal sweating is quite common in diabetics. This occurs as a result of high levels as well as low levels of blood sugar in the body. Additionally, nerve damage that is also quite common in diabetics is another reason for an individual to sweat abnormally.[2]
Thus it is vital for a diabetic to keep tight control of blood sugar levels and adhere to a diet and medications as prescribed by the physician to prevent abnormal sweating. It is again important to seek medical consultation if an individual feels that he or she has been sweating abnormally or there is complete lack of sweat. This is because it normally indicates uncontrolled diabetes and treatment should be started immediately to prevent unwarranted complications.[2]
