Sweating is a normal body function that occurs in response to a rise in body temperature. While not exactly pleasant (and even sometimes downright embarrassing), sweating is the body’s way of cooling things down. Some people sweat more than others, and there are people who don’t sweat at all. Having diabetes can make it hard to regulate your body temperature. Learn more about why this can happen, why you may sweat more at certain times, and what you can do to help you sweat more “normally.”
Why we sweat
Hot summer days, job interviews, exercise, fevers, spicy foods, first dates, public speaking … all of these events can cause sweating, ranging from moist palms to damp armpits to rivulets of moisture pouring down your face. It may seem rather gross to sweat, and sometimes sweating doesn’t smell so nice, either (hence, deodorant). But sweating is normal, and there’s a reason for it: it helps us stay cool, or rather, at a normal temperature.
The typical body temperature is about 98° Fahrenheit (give or take). If your internal temperature climbs too much above that, the hypothalamus in the brain signals your sweat glands, called eccrine glands, to “chill” by producing sweat. The eccrine glands (of which there are a few million) are all over the body, and they are responsible for perspiration. Sweat evaporates from the skin, which removes heat, making you feel cooler.
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Why diabetes can cause sweating
There are several reasons why diabetes can cause excessive sweating. There are three types of excessive sweating:
• Hyperhidrosis, which is essentially excessive sweating. This can occur over the entire body, but tends to occur in the underarms, on the back, and on the hands.
• Gustatory sweating, which is sweating that occurs around eating. If you tend to sweat on your face, head, or neck during or after eating, you may have gustatory sweating. This type of sweating is generally seen in someone who has had diabetes for a long time, and is linked with peripheral neuropathy, kidney disease, and other conditions that can disrupt the autonomic nervous system.
• Night sweats, which is excessive sweating that happens at night. It can soak your pajamas and your sheets, and tends to wake you up. Night sweats may occur due to hypoglycemia, or low blood sugars.
Let’s take a close look at these three types of sweating and why they might occur.
Hyperhidrosis is excessive sweating that can occur due to reasons other than warm weather or doing a lot of exercise. Primary focal hyperhidrosis happens because overactive nerves signal the sweat glands to do their thing, even if the temperature is cool. Stress, nervousness, and anxiety can worsen the problem. The palms of the hands, soles of the feet, and sometimes the face are affected, although the entire body can sweat, too.
Hyperhidrosis that occurs in someone who has diabetes may be related to nerve damage; in this instance, the nerves that regulate the sweat glands are constantly active, which explains the constant sweating.
Also called Frey’s Syndrome, gustatory sweating occurs when eating or drinking any kind of beverage or food (including ice cream!). Sometimes gustatory sweating happens after surgery or trauma to parotid glands, which are the body’s largest salivary glands, according to the International Hyperhidrosis Society. This damage leads to sweating and facial flushing.
But gustatory sweating can happen for other reasons including diabetes, Parkinson’s, cluster headaches, and shingles. Sweating and redness can happen when a person eats, sees, thinks about, or even talks about food. In the case of diabetes, this type of sweating can be seen in long-standing diabetes and in conjunction with kidney disease, peripheral neuropathy and autonomic neuropathy.
Night sweating (or sweats) may occur because of hypoglycemia. During the night, the body uses carbohydrate that you’ve eaten to repair and restore. If you haven’t had enough carbohydrate, have taken too much insulin, or have done more-than-usual exercise, blood sugar levels can drop, and that can cause sweating.
Low blood sugars can activate the autonomic nervous system, which helps regulate sweat production. Adrenaline, a hormone released during time of stress, is another possible cause of sweating.
It’s important to check your blood sugar if you sweat during the night. If it’s lower than 70 mg/dl, or a target that your provider recommends, you’ll need to treat the low with a source of carbohydrate. Continuous hypoglycemia at night should be addressed with your provider to possibly change your diabetes treatment plan.
Keep in mind that night sweats may result from conditions other than diabetes, and include:
- Menopause-related hot flashes
- Thyroid issues
- Heart attack
- Some types of cancer
- Nervous system disorders
Treating excessive sweating
The treatment and management of excess sweating depends on the cause and the severity. Below are common ways to treat or control sweating:
- Clinical-strength or prescription anti-perspirants that contain aluminum chloride.
- Prescription creams that contain glycopyrrolate, which can help with gustatory sweating.
- Nerve-blocking medications called anticholinergics. These can lead to dry mouth, bladder problems, and blurry vision.
- Botulinum toxin injections, which temporarily block the nerves that cause sweating.
- Microwave therapy, which uses microwave energy to destroy sweat glands.
- Sweat gland removal.
- Nerve surgery.
Don’t overlook lifestyle remedies that may be helpful, such as:
- Drinking water regularly.
- Nonprescription antiperspirants.
- Astringents that contain tannic acid.
- Bathing regularly.
- Shoes made from natural materials, and moisture-wicking socks.
- Changing socks often and drying your feet each time you change them.
- Clothing that allows your skin to breathe, made from natural fibers.
- Active-wear clothing made from moisture-wicking fabrics.
- Relaxation techniques.
- Blood sugar management, which includes healthy eating, physical activity, medications, and blood glucose monitoring.
For more information about sweating, as well as additional types of treatment, visit the website of the International Hyperhidrosis Society.
Want to learn more about diabetes and skin health? Read “Sticky Issues: Dealing with Diabetes Device Adhesive and Skin Problems,” “Skin Cancer: Types, Risk Factors, Prevention, and More,” and “Diabetic Dry Skin.”