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Understanding Nocturnal Itching in Diabetes: Causes and Management

Nocturnal Itching in Diabetes

Nocturnal itching can be a troublesome issue for individuals with diabetes. While diabetes itself may be a contributing factor, there are other potential causes to consider.

Factors such as weather fluctuations, allergies, the use of harsh soaps, hormonal changes, and frequent bathing can also lead to nighttime itchiness. In this article, we’ll explore the possible causes and effective strategies for managing itchy skin at night.

Diabetes-Related Nocturnal Itching: Exploring the Underlying Causes

Between 30% and 70% of individuals with either type 1 or type 2 diabetes experience various skin symptoms. In some cases, these skin issues can serve as the initial warning signs of underlying blood glucose problems. While not all diabetes-related skin conditions lead to itching, several do. Here are some common diabetes-related causes of itchy skin:


Diabetic neuropathy can develop in individuals with diabetes due to prolonged exposure to high blood glucose levels, which can damage nerves over time. This condition typically affects the extremities, such as the legs, feet, and hands.

The inflammation of nerves and the release of cytokines during this inflammatory process can contribute to neuropathy-related itching. Imbalances in the body’s antioxidant system may also play a role.

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Aside from itching, diabetic neuropathy often manifests as sensations of burning, tingling, and numbness. Since neuropathy can lead to severe diabetes complications, it’s crucial to stay committed to your healthcare appointments and follow footcare recommendations. Please Fill out this form to check if you or a friend qualify for CGMs.

Skin Infections

Approximately one out of every five individuals with diabetes develops skin infections, including fungal and yeast infections, which can be responsible for nighttime itching.

Impaired wound healing resulting from diabetic neuropathy and poor circulation caused by elevated glucose levels can increase the risk of infections. Excessive scratching due to other skin conditions can further exacerbate the issue.

It is vital to inform your doctor promptly about any non-healing wounds, especially if you have diabetes. Extra precautions may be necessary to maintain the affected area’s cleanliness and prevent infections.

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Dry Skin

People living with diabetes are more susceptible to developing dry skin compared to the general population. Elevated blood sugar levels can contribute to this problem. When there is an excess of sugar in the body, it draws fluid from cells to produce additional urine, leading to dehydration. Poor circulation can also be a contributing factor to dry skin.

Itchy Skin Conditions

Individuals with diabetes are at a higher risk of developing specific skin conditions that cause itching. Being aware of these potential risks can help in obtaining the right diagnosis and treatment. Some common itchy skin conditions associated with diabetes include:


Eczema is an inflammatory skin condition and one of the most prevalent causes of itching, affecting over 31 million Americans. The most prevalent form of eczema is known as atopic dermatitis.

People with eczema often experience symptoms such as itching, rashes, discoloration, and blisters in response to allergens or irritants. Those with food or seasonal allergies are more susceptible to eczema, and genetic factors can also increase the risk.

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Management of eczema involves avoiding triggers and maintaining a proper skincare routine. Antihistamines and topical steroids can provide relief. In severe cases, additional medications may be required.


Psoriasis is an autoimmune skin disease associated with diabetes. It leads to the rapid growth of skin cells, resulting in itchy, scaly patches. Various types of psoriasis exist, each with different treatment options, such as topical ointments, light therapy, and medications. Lifestyle improvements recommended for diabetes can also benefit individuals with psoriasis.

Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a painful and sometimes disfiguring skin disease, with a notable association with diabetes. Although itching isn’t a primary symptom of HS, the affected areas can cause significant discomfort and may become infected, leading to itching and other sleep-disrupting symptoms. The chronic inflammation associated with HS results in skin lesions in areas like the armpits and groin.

Lichen Planus

Lichen planus is an inflammatory skin disorder that can lead to itchy bumps on the wrists, ankles, or near mucous membranes. Approximately 25% of individuals with lichen planus also have diabetes, although the exact connection remains unclear. Consulting an experienced dermatologist is essential for a proper diagnosis.

Prurigo Nodularis

Continuous itching can lead to prurigo nodularis (PN), a condition characterized by hard bumps or nodules on the skin, causing intense itching and negatively impacting one’s quality of life and sleep. PN often develops after prolonged scratching resulting from other skin conditions or systemic inflammatory issues like diabetes. Both the diagnosis and treatment of this illness can be difficult.

Tips to Alleviate Nocturnal Itching

For mild symptoms, making simple changes can offer relief, such as applying moisturizer after a shower or wearing softer fabrics to bed. Staying well-hydrated by drinking plenty of water can help prevent dry, itchy skin.

However, if your itching worsens and significantly disrupts your sleep, it’s advisable to consult a dermatologist for a comprehensive evaluation. Based on your symptoms and medical history, they may recommend blood tests or skin biopsies for further investigation. Management options may include topical creams, corticosteroids, phototherapy, antibiotics, or biologic immunosuppressant drugs.

Additionally, improving your sleep quality can involve maintaining a cool bedroom temperature and reducing caffeine intake. If needed, consider discussing the possibility of a sleep study with your doctor to identify any other factors contributing to your sleep disturbances.

In conclusion, addressing the potential causes of itchy skin at night is essential, especially for individuals with diabetes. Seeking timely medical attention can help alleviate discomfort and improve your overall well-being. Don’t hesitate to prioritize your health and well-being by consulting healthcare professionals who can provide personalized guidance and treatment.