Sweating in Diabetes: High Blood Sugar vs. Low Blood Sugar Symptoms

Sweating

Hello Dr.
Chen:
1.
Do diabetes patients sweat more than normal individuals when their blood sugar is high? How can one differentiate this from cold sweats due to hypoglycemia?
2.
If blood sugar levels are significantly higher than usual (possibly due to forgetting to take medication), what should be done? At what blood sugar level should one seek medical attention, or is it sufficient to take an additional dose of oral hypoglycemic medication?
3.
If the prescribed oral hypoglycemic medication is taken with breakfast, can it be taken with lunch or dinner instead? What are the differences in effect?
4.
How much can the blood sugar level be expected to decrease after taking 2 mg of Amaryl? Why is it necessary for diabetes patients to reduce glycogen production when glycogen can be rapidly broken down to provide glucose when supply is insufficient, thus maintaining stable blood sugar levels?
5.
Is it permissible to switch medications before finishing a month's supply?

Mingming, 30~39 year old female. Ask Date: 2008/07/23

Dr. Chen Qingbin reply Internal Medicine

Sweating requires blood glucose testing to confirm if it is hypoglycemia.
Each individual has different tolerances to blood sugar, and the type and dosage of medication must be evaluated by the attending physician.

Reply Date: 2008/07/23

More Info

Understanding the symptoms of sweating in diabetes, particularly in relation to high and low blood sugar levels, is crucial for effective management of the condition. Here’s a comprehensive breakdown of your questions.

1. Sweating in High vs. Low Blood Sugar: In diabetes, sweating can manifest differently depending on whether blood sugar levels are high or low. Typically, low blood sugar (hypoglycemia) can cause symptoms such as cold sweats, shakiness, anxiety, and palpitations. This is due to the body’s release of adrenaline in response to low glucose levels, which triggers sweating as part of the fight-or-flight response. On the other hand, high blood sugar (hyperglycemia) does not usually cause increased sweating directly. Instead, it may lead to dehydration, which can reduce sweating. However, if a person is experiencing high blood sugar levels due to an infection or other stressors, they might sweat more than usual due to the body’s response to these conditions. To differentiate between the two, pay attention to accompanying symptoms: cold, clammy skin and shakiness suggest low blood sugar, while symptoms like excessive thirst, frequent urination, and fatigue indicate high blood sugar.

2. Managing High Blood Sugar Levels: If you find that your blood sugar is significantly higher than usual (for example, due to forgetting to take medication), the first step is to confirm the reading with a reliable meter. If your blood sugar is above 300 mg/dL, it is advisable to consult a healthcare provider, especially if you are experiencing symptoms like nausea, vomiting, or abdominal pain, which could indicate diabetic ketoacidosis (DKA). In many cases, if your blood sugar is moderately elevated, you may be able to take your prescribed medication to lower it. However, never double up on medication without consulting your doctor, as this can lead to dangerous drops in blood sugar.

3. Timing of Blood Sugar Medication: If your diabetes medication is prescribed to be taken with breakfast, it is generally best to follow that schedule. Taking it at lunch or dinner may alter its effectiveness and how your body responds to food intake. Medications like Metformin are designed to work optimally when taken at specific times, as they help manage blood sugar levels in relation to meals. Always consult your healthcare provider before making changes to your medication schedule.

4. Effect of Amaryl (Glimepiride) on Blood Sugar: Amaryl, which is a sulfonylurea, works by stimulating the pancreas to release more insulin. The exact reduction in blood sugar levels can vary widely among individuals, but it typically lowers blood sugar by about 1-2% in terms of HbA1c levels. The goal of reducing glycogen production in the liver is to prevent excessive glucose release into the bloodstream, which can occur when blood sugar levels are already high. While glycogen serves as a quick source of glucose during fasting or low intake, in diabetes, the regulation of glucose production and utilization is impaired, necessitating careful management of both dietary intake and medication.

5. Switching Medications: It is generally possible to switch medications before finishing a month's supply, but this should always be done under the guidance of a healthcare provider. They will consider factors such as your current blood sugar control, side effects, and any other health conditions you may have. Abruptly changing medications without professional advice can lead to complications or ineffective management of your diabetes.

In conclusion, managing diabetes requires a comprehensive understanding of how various factors affect blood sugar levels, including medication timing, symptoms of high and low blood sugar, and the physiological roles of glucose and glycogen. Regular monitoring, adherence to prescribed treatments, and open communication with healthcare providers are essential for effective diabetes management. If you have further questions or concerns, please consult your healthcare provider for personalized advice.

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