Sweating is the body’s natural way of regulating temperature, but for some people, excessive sweating can be more than just a response to heat or exercise; it can be a medical condition known as hyperhidrosis. When this excessive sweating is caused by another underlying health condition, such as diabetes, it’s known as secondary hyperhidrosis.
In this blog, we’ll explore what secondary hyperhidrosis is, how it can be linked to diabetes, and what practical steps can help manage symptoms on a day-to-day basis.
What Is Secondary Hyperhidrosis?
Hyperhidrosis can be classified as primary or secondary.
- Primary hyperhidrosis occurs without a known cause and usually affects specific areas such as the hands, feet, underarms, or face. There is no underlying medical condition.
- Secondary hyperhidrosis, however, develops as a symptom of another condition or a side effect of medication. It often causes generalised sweating (across large areas of the body) and can occur suddenly rather than being constant.
Secondary hyperhidrosis can be triggered by a wide range of conditions, including:
- Metabolic or hormonal conditions such as diabetes, hyperthyroidism, pregnancy or menopause
- A side effect of certain medications, such as antidepressants, heart and blood pressure medicines or painkillers
- Infections such as COVID or flu cause a fever and sweating as part of the body’s response to the infection but sweating settles as the infection resolves. Sweating at night can be a sign of tuberculosis infection (TB) and needs to be checked out by a doctor.
- Neurological conditions such as Parkinson’s disease
- Autoimmune conditions such as rheumatoid arthritis and Raynaud’s
When diabetes is involved, the link can be both physiological and neurological, and understanding how this occurs can help explain why sweating becomes such a persistent problem.
How Diabetes Can Cause Excessive Sweating
People living with diabetes may experience episodes of excessive sweating for a few different reasons. The most common are low blood sugar (hypoglycaemia), autonomic neuropathy, and related gustatory sweating.
1. Hypoglycaemia (Low Blood Sugar)
One of the most common causes of sweating in diabetes is a drop in blood sugar levels. When blood sugar becomes too low, the body releases adrenaline (epinephrine) and other stress hormones in response. This “fight or flight” response can trigger sudden, intense sweating, often accompanied by shakiness, dizziness, or heart palpitations.
This type of sweating is typically short-term and resolves once blood sugar levels return to normal, but it can be alarming and uncomfortable. For people who experience frequent hypoglycaemia, it can happen several times a week or even daily.
2. Diabetic Neuropathy
Long term high blood sugar levels can damage nerves. Sensory nerves can inappropriately produce sensations of numbness, tingling or pain. The autonomic nerves that control non-conscious processes like heart rate, digestion, and sweating can also be affected.
In some cases, this nerve damage can cause increased sweating, especially at night or after eating. In others, it may lead to reduced sweating in certain areas and excessive sweating elsewhere as the body tries to compensate.
For example, some people with diabetic neuropathy may find they don’t sweat below the waist, but sweat excessively on the upper body or face, especially during meals (a condition known as gustatory sweating).
3. Gustatory Sweating
Gustatory sweating in diabetes is also caused by neuropathy. Tasting, smelling, even the sight or thought of food triggers excessive sweating on the face, scalp, neck or body making social situations uncomfortable. Gustatory sweating is more common in people following surgery to the salivary glands at the side of the face which is not related to diabetes.
4. Medication side effects
Sweating can also be a side effect of the medications taken to control diabetes. Insulin and other anti-diabetic drugs can cause sweating as a side effect.
Recognising the Symptoms
Diabetes-related sweating can appear in different patterns. Some people experience:
- Night sweats, even in cool environments
- Upper body sweating, especially on the head, neck, or chest
- Sweating while eating or thinking about food
- Sweating during hypoglycaemic episodes
- Dryness or lack of sweating in other parts of the body
If sweating patterns change significantly, especially if they occur alongside dizziness, fatigue, or nerve pain, it’s worth discussing symptoms with a GP, diabetes nurse, or endocrinologist.
Managing Secondary Hyperhidrosis in Diabetes
Managing secondary hyperhidrosis starts with treating the underlying cause, in this case, maintaining stable blood sugar levels and managing diabetic neuropathy.
However, there are also practical ways to control and reduce the impact of excessive sweating on daily life.
1. Review Medication and Blood Sugar Control
If you have a sudden onset of increased sweating it is very important to speak to your GP or diabetes specialist about whether your medication or diabetes could be contributing to sweating. Regular monitoring and adjustment of insulin or other diabetes medications can help stabilise glucose levels and reduce hypoglycaemia-related sweating. Long-term consistent blood sugar level control is important to try and prevent the issues described above.
2. Choose Clothing That Breathes
Natural fabrics such as cotton, bamboo, or linen allow air to circulate and absorb moisture better than synthetic materials. Layering light, breathable fabrics can also make it easier to manage temperature throughout the day.
3. Use Targeted Antiperspirants
Clinical strength antiperspirants, such as SweatStop® products, may help manage sweating on specific areas like the underarms, hands, or feet.
4. Keep Skin Care Simple and Soothing
Gentle skincare products can help prevent irritation, especially if sweating leads to chafing or rashes. Look for fragrance-free, pH-balanced products and keep skin dry between applications.
5. Healthy lifestyle
Leading a healthy life with regular moderate exercise, relaxation techniques, and good sleep may help improve autonomic balance and diabetic control.
6. Consider Medical Treatments
If sweating becomes severe or persistent, prescription medications such as anticholinergics may be discussed with a healthcare provider. These are usually recommended for those whose sweating doesn’t improve with topical products or lifestyle changes.
When to Seek Professional Support
Excessive sweating can have a major impact on comfort, sleep, and confidence. If it begins to affect your quality of life, or if you’re unsure whether it’s linked to blood sugar levels, medication, or nerve changes, speak to your healthcare team as a matter of urgency.
A doctor can rule out other causes, review medication side effects, and discuss suitable treatment options. You can also visit specialist resources such as
Hyperhidrosis UK, which offers detailed information, treatment advice, and patient support for people living with all forms of excessive sweating.
Living Comfortably with Diabetes and Hyperhidrosis
While sweating is a natural and necessary function, secondary hyperhidrosis can make daily life more challenging, from choosing clothes to managing sleep and social situations. The good news is that with the right combination of blood sugar management, targeted skincare, and medical advice, most people can regain control and confidence.
Understanding the link between diabetes and hyperhidrosis is the first step toward relief. And with ongoing research, awareness, and access to effective treatments, living well with both conditions is entirely possible.
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