Sweating a lot can be uncomfortable, embarrassing, and disruptive to daily life. Many DiabetesTeam members have also shared how excessive sweating is a symptom of their diabetes.

“I found out I have diabetes,” one member said. “From the beginning, I had face and neck heavy sweating. I had to keep a cold cloth with me at all times.”

Another said, “I sweat terribly, especially when I eat.”

A third member added, “I get drenched so badly I have to change clothes two to three times a day.”

Hyperhidrosis (sweating excessively) happens when sweat glands are more active than needed to regulate body temperature. For some people, hyperhidrosis occurs on its own. For others, it can develop as a result of other medical conditions, such as type 2 diabetes.

Why does diabetes cause this bothersome symptom? Here, we explore why diabetes may cause excess sweating.

Blood Glucose Levels

If you’re living with diabetes and find yourself extra sweaty, it may be due to changing blood glucose (sugar) levels. Hypoglycemia (low blood sugar), in particular, may be the culprit.

When blood sugar levels dip too low, your body releases a hormone called epinephrine. Also called adrenaline, it’s referred to as the “fight-or-flight” hormone because of how it stimulates the body. Epinephrine tells the body to release stored sugars for energy, which is helpful when blood sugar levels are low. But it also triggers other changes within the body, such as sweating and fast heart rate.

If you’re sweating due to hypoglycemia, you may also notice that you:

• Feel dizzy, lightheaded, or shaky
• Have a headache, blurry vision, or other visual problems
• Feel nauseous or hungry
• Experience heart palpitations
• Look pale
• Are irritable or moody, or otherwise behaving differently than normal
• Are confused or have difficulty paying attention
• Are moving in a jerky or clumsy manner
• Feel a tingling sensation near your mouth

You can also develop low blood sugar overnight. This can happen for several reasons, such as exercising before bed, drinking alcohol, or taking too high a dose of insulin.

If hypoglycemia occurs while you sleep, it can cause symptoms, such as:

• Sweating that makes pajamas or bedding damp
• Nightmares or restless sleep
• Confusion, tiredness, or irritability upon waking up
• Difficulty waking from sleep
• Seizures

As one DiabetesTeam member explained, “When my blood sugar is low — almost always at night — I sometimes wake up with the sheets soaked through and just dripping in sweat.”

If you’re using a glucose monitor for diabetes management, you may see these symptoms when glucose levels are around 70 milligrams per deciliter (mg/dL). However, if you often have high blood sugar, you may experience symptoms at higher levels.

Nerve Damage

Diabetes-related neuropathy (nerve damage) can also cause excess sweating. This is because blood sugar levels that are consistently high can damage nerves. The two most common types of diabetes-related nerve damage are peripheral neuropathy and autonomic neuropathy.

Peripheral neuropathy — damage to nerves outside the spinal cord — is estimated to affect around half of those with diabetes. People with this type of nerve damage tend to have symptoms in the feet, legs, and hands.

Autonomic neuropathy describes damage to the part of your nervous system responsible for involuntary processes like blood pressure, digestion, and sweating. Around one-third of people with diabetes will develop autonomic neuropathy.

When autonomic nerves are damaged, they can disrupt how your body works. The body processes that are disrupted will vary depending on which nerves are affected. If it impacts nerves related to your sweat glands, it can cause you to either sweat too much or too little.

Gustatory Sweating

According to the American Diabetes Association (ADA), gustatory sweating — sweating of the face and neck after eating or smelling food — is caused by autonomic nerve dysfunction. Also called Frey’s syndrome, this type of sweating can be triggered by all food or by specific meal choices. Spicy foods, fatty foods, soups, cheese, and sugary foods have all been reported to cause this type of sweating.

One study found that gustatory sweating was around twice as common in people with diabetes mellitus as in those without. The study authors also noted that those with diabetes tended to sweat longer than people without the condition — 10 to 30 minutes compared to less than 10 minutes. Sweating more commonly occurred over the entire body in people without diabetes, while sweating tended to be only on the head and upper body in those with diabetes.

Other Causes of Excess Sweating

There may also be other reasons for your excessive sweating. Some diabetes medications, such as insulin, can cause sweating as a side effect. Excess sweating can also be due to medical conditions besides your diabetes — other common causes of excess sweating include:

• Menopause
• Obesity
• Anxiety disorders
• Overactive thyroid
• Infections

Excess sweating may also be a symptom of serious medical conditions like cancer, heart disease, and Parkinson’s disease. Blood sugar levels that are dangerously low can be life-threatening. Seek immediate medical attention if you’re sweating and have other symptoms of very low blood sugar, such as confusion, slurred speech, or double vision.

Managing Excess Sweating

Using antiperspirants with aluminum may help you keep sweating under control. Also, lifestyle changes like dressing in loose, breathable fabrics and taking more showers or baths can help you manage symptoms. That said, the best way to manage excess sweating will depend upon what’s causing it.

There are also medications for sweating, including glycopyrrolate, which may be used if the sweating is severe and affects your daily life. This medication is usually prescribed by a dermatologist who can help you assess whether its benefits outweigh its risks and side effects.

For sweating due to low blood sugar, the ADA recommends eating or drinking 15 grams of sugar (carbohydrates) to correct your levels. If your blood sugar remains low 15 minutes later, consume another 15 grams of sugar. Following your diabetes care plan by taking your medications and wearing a glucose monitor may help prevent low blood sugar and its symptoms.

If your excess sweating is caused by nerve damage, talk to a healthcare professional about your treatment options. Your healthcare provider may recommend managing severe symptoms with Botox injections, anticholinergics applied to the skin, or surgery.

Talk to Your Doctor

There’s no need to avoid activities you enjoy, such as dining out, to avoid feeling embarrassed by your sweating. If excess sweating negatively affects your quality of life, talk to your healthcare provider. Your doctor can help you determine the cause of your excess sweating and how best to manage it.

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