7 Causes of Excessive Perspiration in People with Diabetes

Unless the weather is sweltering or you’re having hot flashes, excessive sweating is most likely an indication of a greater health issue. Ask yourself:

• Do you have a fever or other signs of an infection?
• Are you in any pain when you sweat?
• Is the sweating mainly on one side?
• Does it involve your palms, soles, and/or armpits?
• Do you sweat while you sleep?
• Is your blood glucose level high (or low) during these sweating episodes?
• Could sweating be a reaction to your diabetes medication?

If the answer is yes to any of these questions, talk to your healthcare provider.

What are the possible causes of excessive sweating?

For people with diabetes, certain complications can affect the sweat glands, making it difficult for the body to cool down in hot weather, triggering heavy sweating even during light activities, or causing sweating in cool temperatures.

1. Autonomic neuropathy.

This is a condition in which hyperglycemia (high blood glucose) interferes with the nerves that control involuntary functions. The autonomic nervous system manages several systems automatically, including bladder control, heart rate, the ability to detect hypoglycemia, and the ability to sweat appropriately. Dry feet are a common symptom of nerve disease, so it is important to inspect your feet daily to be sure there are no cracks from excessive dryness, a condition that tends to occur along with sweating.

2. Low blood glucose levels.

A low blood glucose level is called hypoglycemia. Hypoglycemia triggers a fight-or-flight response in the body. As a result, the body produces additional norepinephrine and adrenaline, which can lead to heavy sweating as well as shakiness and anxiety. Good diabetes management can help keep your blood glucose levels in check.

3. Heart problems.

People with diabetes have an increased risk of cardiovascular disease. Excessive sweating can be a sign of heart failure, heart attack, or stroke. If you are also experiencing shaking, chills, and fever, get to your healthcare provider or emergency room right away.

4. Kidney disease. 

Sweating can be an indication of kidney disease, but it is also a common complaint for people who have already been diagnosed with CKD, or chronic kidney disease. Their blood glucose is even more likely to be impacted, they may experience sweating as a side effect of medications, and they may experience low blood pressure, which can also cause sweating. Getting regular checkups for your kidneys is important. If you have already been diagnosed with CKD, make sure your kidney treatment is on track.

5. Medications.

Some medications are necessary for diabetes management, but they can also lead to side effects, such as excessive sweating. These drugs include:

• Psychiatric drugs
• Blood pressure medications
• Medicines for dry mouth
• Antibiotics
• Supplements

If it is determined that your medication is causing your excessive sweating, your healthcare provider may be able to give you a different prescription.

6. Obesity.

A common diabetes co-morbidity is obesity, one of the risks for heart disease. Sweating and obesity typically go hand-in-hand, but even for someone with obesity, extreme sweating on a consistent basis can be cause for concern, and should be discussed with a healthcare provider.

7. Stress.

Stress can certainly raise blood glucose levels and can cause sweating. It can also force the heart to work harder, prompting what can appear to be signs of heart attack or heart failure. Talking with a psychologist or professional counselor can be the first step to managing stress—and, hopefully, decreasing sweating.

Types of excessive sweating and treatment

There are three main types of sweating, each with its own treatment.

Hyperhidrosis is excessive sweating not caused by temperature or exercise. This condition can be diagnosed by a skin specialist, neurologist, or endocrinologist. Lab and sweat tests will most likely be in order. Treatment usually involves medications such as:

• Nerve-blocking medication
• Prescription antiperspirant
• Botox injections
• Antidepressants

In extreme cases, surgery may also be an option. 

Gustatory sweating is caused by spicy foods or cheese. This type of sweating is limited to face and neck areas, but diagnosing this condition is not as simple as taking a test, so paying attention to your symptoms and effectively reporting them to your doctor will go a long way. Gustatory sweating can often be helped by a scopolamine transdermal patch, more commonly used to prevent the nausea and vomiting caused by motion sickness.

Night sweats are typically caused by low blood glucose during the night. Good diabetes management is the best treatment for this type of sweating, including regular blood glucose testing and treatment if glucose is low, adjusting your exercise schedule, and having a snack just before bed to curb low blood glucose while you sleep. Work with your healthcare provider or dietitian to manage wayward blood glucose numbers.

Lifestyle changes may also help people who experience excessive sweating. Consider:

• Wearing natural fabrics for your clothing and shoes, such as cotton and leather
• Wearing clothing that takes moisture away from the body for exercise or intense activity
• Changing socks daily, or whenever they become sweaty
• Not wearing the same pair of shoes day after day

Sweating too much, even when the temperature is cool, when you’re at rest, or at other unusual times, is not normal. It can be an embarrassing condition that may even lead to skin irritation, compounding the emotional toll on the sufferer. Excessive sweating may also point to a very treatable underlying condition, so take note of your symptoms, and talk to your healthcare provider.

Monica Dennis is the former managing editor of dLife.