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March 8, 2003

Diagnosis and Symptoms

Question from Bhopal, India:

My three old daughter has type 1 diabetes, and sweats profusely whenever she sleeps. I have checked her sugars which are 180-240 mg/dl [10-13.3 mmol/L]. Apart from that she is always warm but doesn't have any temperature.

Answer:

Your daughter’s profuse sweating is rather unlikely to be due to nocturnal hypoglycemia if her blood sugars in that range, and furthermore, she does not have a temperature (fever). There are several other possible causes for the symptoms, and I think she might have a very early kind of autonomic dysfunction of upper body sweating that may appear quite early in type 1 diabetes, especially when there is a history of not very good control. See Hoeldtke RD, Bryner KD, Horvath GG, Phares RW, Broy LF, Hobbs GR. Redistribution of sudomotor responses is an early sign of sympathetic dysfunction in type 1 diabetes. Diabetes 2001 Feb;50(2):436-43, and ask your daughter’s pediatrician for further help on how to evaluate this hypothesis.

MS