Hidradenitis suppurativa (HS) is a condition that causes painful, swollen bumps and scarring on the skin. These bumps can contain pus or blood, and they mainly occur in the armpits and groin. HS can happen on its own or alongside other health conditions. For example, having HS increases the risk of developing diabetes. In one large study, researchers found that about 10.6 percent of people with HS had diabetes, compared to just 3.8 percent of those in the general population. Put another way, diabetes occurs three times more often in people with HS.

If you have HS, it may help to talk to your doctor about your risk of diabetes. Certain lifestyle changes may help lower the risk of developing diabetes. Additionally, if you are diagnosed with diabetes and HS, several treatments can help you manage both conditions.

Diabetes: An Overview

Diabetes mellitus, also called diabetes, is a medical condition in which the body does not use sugar properly. Sugar, or glucose, is the main fuel that all of the cells in the body use for energy. After we eat, sugar is absorbed through the small intestine into the blood. Then, a hormone called insulin helps the sugar pass from the blood into the body’s cells so that they can make energy. In diabetes, either there is not enough insulin or the body’s cells do not respond properly to insulin, and sugar cannot pass into the cells. Instead, sugar builds up in the bloodstream.

Here, we will focus on two main types of diabetes. Type 1 diabetes, which is often more severe, occurs when the body completely stops making insulin. Type 2 diabetes is more common and develops when the body makes low levels of insulin or the body’s cells don’t respond to insulin properly. HS may slightly increase the risk of getting type 2 diabetes.

It’s essential to have regular medical care if you are diagnosed with diabetes. When this condition isn’t properly treated, high levels of sugar in the bloodstream can damage tissues and organs, including the heart, eyes, kidneys, gums, and nerves.

How Are Diabetes and HS Connected?

Experts don’t yet understand why people with HS get diabetes at higher rates. It may be related to unbalanced hormone levels, one of the causes of HS.

People with HS also have ongoing inflammation. Their bodies make inflammatory chemicals that can prevent insulin from working properly, which could trigger diabetes in the long term.

Risk Factors for Diabetes and HS

Certain factors can increase your chance of developing both diabetes and HS. One risk factor for both conditions is metabolic syndrome — a collection of issues such as high blood pressure, high blood sugar levels, and abnormal cholesterol levels. You may also be more likely to develop both diabetes and HS if you have a higher body weight or smoke cigarettes.

Many of these risk factors can be managed. You can try the following lifestyle changes to help prevent both diabetes and HS. On the other hand, if you have already been diagnosed with HS, making these changes may reduce your risk of diabetes:

• Quit or cut down on cigarette smoking.
• Eat a well-balanced diet high in vegetables, fruit, grains, and protein as much as possible.
• Limit saturated fat, highly processed foods, and foods containing high levels of refined sugars.
• Participate in physical activity that is enjoyable and feels good for your body.
• Visit your medical provider to check your blood pressure, blood sugar, and cholesterol levels.
• Consider getting screened for mental health conditions like anxiety and depression, which are common and can have other consequences on your health.

Symptoms of Diabetes

If you have HS, be mindful of the signs and symptoms of diabetes, which may include:

• Unusual thirst or hunger
• More frequent urination, more often than usual
• Tiredness or weakness
• Irritability or grumpiness
• Unexpected weight loss
• Vision changes, including blurry vision
• Wounds that don’t heal or heal slowly
• Frequent infections
• Tingling, numbness, or a pins-and-needles sensation in your hands or feet

Diabetes doesn’t always cause symptoms — in fact, about 1 out of 5 people with the condition don’t know they have it. For this reason, you may want to ask your doctor about diabetes testing if you have HS or other factors that increase your risk of diabetes, such as a family history.

Treating Diabetes While Living With HS

If you have both diabetes and HS, work with your health care team to find a treatment plan that helps you manage both conditions. Fortunately, some lifestyle changes and medications can improve diabetes and HS at the same time. However, treatments for one condition can occasionally make it more difficult to manage the other condition.

Treating diabetes early may be especially important for people with HS to avoid more serious medical problems in the future, including heart disease.

Lifestyle Changes for Diabetes and HS

For some people, weight loss may improve diabetes symptoms and allow them to take less medication. Weight loss may also improve HS — in one study, researchers found that when people with HS lost at least 15 percent of their body weight, close to half had their HS clear up. Remember, however, that weight loss may not be a desired or appropriate goal for everyone — make sure that you first discuss any weight changes with your health care team.

Diet changes may also help manage both conditions. Diets that help with diabetes often emphasize eating more plant-based foods as well as staying away from foods that are highly processed. Eating more fruits, vegetables, and whole grains and consuming less sugar, especially refined sugar, may also reduce symptoms of HS. Some people find that it helps to eliminate alcohol. If you feel that eliminating other food groups would help your HS, it is best to work with a registered dietitian to monitor your progress.

In particular, you may want to try the Mediterranean diet. This eating plan can reduce your risk of diabetes. It can also help you better control your blood sugar and insulin levels if you already have the condition. Additionally, following the Mediterranean diet may lead to fewer flare-ups of HS symptoms.

Physical activity can help your cells better use insulin. This means that being more active can prevent diabetes as well as help treat it. Furthermore, people with HS who exercise more tend to have less severe disease. However, if you have HS, make sure that your exercise clothing prevents skin from chafing (rubbing together), as this can create nodules or lesions on your skin.

Medications

Insulin is a necessary treatment for everyone with type 1 diabetes as well as some people with type 2 diabetes. If you need this treatment, you will have to regularly check your blood sugar levels and take insulin through a syringe, pen, pump, or inhaler if your blood sugar rises too high.

Other types of medications can also help. They may encourage your body to make more insulin, stop your body from making extra sugar, or allow your cells to use blood sugar more effectively. Your doctor can help you figure out which medication is the best fit for you.

One diabetes medication, metformin, is also sometimes used to treat HS. It’s not entirely clear why this drug helps, but it may balance hormones or help skin cells use glucose more efficiently. People with both diabetes and HS may improve their quality of life with this treatment.

On the other hand, some HS treatments may affect your diabetes. Taking hormonal birth control pills for HS can occasionally raise your blood sugar levels or increase your risk of complications, such as high blood pressure. Corticosteroids are often used to treat HS (usually in injection form), but they can also increase your blood sugar levels, so you may need to take a lower dose if you have diabetes. If you develop diabetes, make sure to tell your dermatologist so they can make sure your HS treatments are appropriate.

Talk With Others Who Understand

On myHSteam, the social network for people with hidradenitis suppurativa and their loved ones, more than 30,000 members come together to ask questions, give advice, and share their stories with others who understand life with hidradenitis suppurativa.

Are you living with hidradenitis suppurativa? Has your doctor talked to you about diabetes? Share your experience in the comments below, or start a conversation by posting on your Activities page.