Excessive sweating, known as polydipsia is a common symptom of diabetes. Excessive sweating can lead to hypothalamic-pituitary-adrenal (HPA) axis disruptions which are the underlying cause for hypoglycemic crisis or hyperglycemia. The HPA axis governs hormonal responses in response to stressors such as psychological, physical and environmental stressors. Hypoglycemia is often seen with type 1 diabetics because they frequently have poorly controlled diabetes and may also have insulin resistance making them more prone to hypoglycemia episodes. Hyperglycemia on the other hand is usually associated with types 2 or 3 diabetics who have had their condition for some time before being diagnosed thereby increasing an individual’s risk of developing long term complications from high blood sugar levels due to insulin resistance syndrome
How does excessive sweating occur?
The thinking behind this theory behind the excessive sweating in people with diabetes stems from evidence that diminished adrenergic activity occurs when there are abnormalities at multiple sites within the HPA Axis; namely: eicosanoid production, cortisol synthesis and release, mineralocorticoid receptor function and ACTH secretory capacity (the primary hormone involved in the HPA axis). This leads directly into increased sympathetic nervous system stimulation causing vasoconstriction resulting in peripheral vascular disease including diabetic microangiopathy which ultimately leads into neuropathy. It should be noted however that patients who do not sweat excessively despite having many symptoms of neuro