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What sweating can tell you about sugar levels
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What sweating can tell you about sugar levels

Experts point out that unexplained sweating could be either due to low blood sugar or nerve damage due to diabetes

Irregular bouts of sweating or lack of adequate sweating are often connected with variations in our blood glucose levels

Unfortunately, the phrase ‘don’t sweat about it’ is not applicable when it comes to people living with diabetes. Both excessive and less-than-usual bouts of sweating without any valid reason could indicate volatile blood sugar levels, especially low blood sugar. Emphasizing the link between sweating and diabetes, endocrinologists point out that such sudden episodes without any bearing on external factors like physical activity, ambient temperature or other stress factors call for immediate medical intervention in the case of people with diabetes.


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Low blood sugar and sweating

Excessive sweating, not always linked to physical activity or heat, is termed hyperhidrosis.

Dr Archana Juneja, consultant endocrinologist, Kokilaben Dhirubhai Ambani Hospital, Mumbai, points out that a dip in sugar level could be the main reason for sudden unexplained excessive sweating.

“Whenever the sugar level in the body dips, the person starts feeling hungry and dizzy which is followed by sweating,” she explains. This sweating doesn’t stop unless the person eats something. This kind of sweating is hypoglycemia-induced. To avoid the sugar level from dropping to very low levels, when such an episode happens, a person should immediately take two spoons of glucose powder and follow it up with a snack, observes Mumbai-based endocrinologist Dr Madhur Maheshwari of Criticare Asia hospital.

According to the American Diabetes Association (ADA), sudden sweating is one of the main symptoms of a dip in blood sugar below the normal level. It is mainly due to the release of adrenaline, to balance the lack of glucose in the blood. It is also listed as an immediate indicator for the individual to adopt the 15-15 rule – have 15 grams of food rich in carbohydrates and check blood sugar after 15 minutes to see if it has become normal.

An article by Dr Rowan Hillson MBE published in Practical Diabetes, in 2017, says that sweating is a cardinal symptom of hypoglycemia, due to adrenaline release as part of the counter-regulatory hormonal response to low glucose.

Autonomic neuropathy-induced sweating

Sweat glands in our body are responsible for perspiration during exertion or high temperatures experienced by the body.  However, in people with diabetes, the functioning of the nerves that control the involuntary functions of the body (including sweating) is affected due to a condition called diabetic autonomic neuropathy.

Dr Juneja explains that diabetic autonomic neuropathy is a manifestation of diabetes-triggered nerve damage affecting the body’s temperature control, sweating, blood pressure, digestion, bladder control and sexual functions.

“These sweating episodes typically happen in the soles of the feet or the palms of the hand. Or when people are eating food, they suddenly start sweating,” she says.

Gustatory sweating and night sweating

Dr Juneja explains that people with diabetes could also experience something known as gustatory sweating which occurs post the consumption of food. This could be a pointer to autonomic neuropathy, she notes.

Another symptom of low blood sugar is night sweating. “Sometimes the diabetic elderly complain of night sweating which is common in instances of low sugar,” she explains. These episodes are also more common in those with type 1 diabetes and people who take insulin shots, especially during evening hours.

Experts also point out that common symptoms of these sweating episodes are also marked by tingling and burning feet while some people may even experience dizziness and anxiety because of low blood pressure. Symptoms like cramps, numb feet and loss of sensation in the feet and hands can be linked to diabetic autonomic neuropathy and need to be taken seriously. “If not attended to timely, it can eventually lead to diabetic foot [a condition where the wounds on the feet take time to heal] and amputation,” warns Dr Maheshwari.

Anhidrosis or the lack of sweating

While people with diabetes can be perturbed by excessive sweating, the lack of sweating can also be a cause of worry.

“This kind of neuropathy in chronic diabetes that generally presents with decreased or low sweating capability is known as anhidrosis,” explains Dr Maheshwari. This condition indicates nerve-degeneration-induced autonomic neuropathy which doesn’t enable perspiration.

“Poor sweating leads to dryness and cracks in the feet, through which infection may seep in, leading to long-standing, poorly healing wounds,” he says.

Blood pressure and sweating

Experts say that if autonomic neuropathy causes sweating, this can affect blood pressure as well. “Postural hypotension happens due to autonomic neuropathy where, when people are sitting or lying down, the blood pressure increases but when they stand, the blood pressure drops,” explains Juneja.

Dr Maheshwari says that while some people receive a prescription for a medicine that temporarily prevents them from sweating, for others, antiperspirant works well. “It also varies from individual to individual and their health conditions,” he adds.

Takeaways

Excess sweating or not sweating at all are equally critical and might require medical intervention, especially in the case of people with diabetes. Sudden and excessive sweating episodes are usually triggered by low blood sugar. However, sweating profusely could also be due to nerve damage suffered due to diabetic autonomic neuropathy. Experts opine that if an individual is experiencing frequent sweating bouts of sweating despite maintaining normal blood sugar levels, then the person should be medically examined for any nerve damage.

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