Hidradenitis Suppurativa and Diabetes

While hidradenitis suppurativa (HS) is known mainly as an inflammatory skin disease, it can affect other aspects of your mental and physical well-being. Pain and scarring from lumps and tunnels beneath the skin can limit movement, as well as daily and social activities.^1,3-5

HS can also raise your chances of developing other health conditions, including type 2 diabetes. This is known as comorbidity, which is 2 or more disorders in the same person. Comorbid illnesses can interact in ways that worsen both.^1,3-5

What risk factors are linked to HS?

Some factors put people at risk for HS. These include:²

• Age – The largest group of people with an HS diagnosis are 30 to 39 years old
• Gender – HS is more common in women than men
• Genetics – Up to 40 percent of people with HS have a family history of the condition
• Race – Black and biracial (Black and white) people are more likely to have HS than white people

Behaviors like smoking and illnesses such as psoriasis can also raise your chances of having HS.²

HS itself can also be a risk factor for disease. Several studies have shown that HS is a risk factor for diabetes.^3,4,5

For example, 1 group of doctors looked at 12 studies focused on HS and diabetes. They shared the results of their assessment at the 2019 meeting of the American Academy of Dermatology. In summary, they found that diabetes is more common in people with HS than in people without HS.³

What is the rate of diabetes in people with HS?

Other studies have focused on the actual rate of diabetes, which was found to be much higher in people with HS.

A group of doctors discovered that the rate of diabetes is 3 times greater among people with HS. The finding is based on a systematic review of 14 studies and a meta-analysis of more than 104,000 people from 7 studies. In these studies, diabetes occurred in 10.6 percent of the people with HS, but only 3.8 percent of the people without HS.⁴

Why is the rate of diabetes higher in people with HS?

Doctors do not fully know why people with HS have higher rates of diabetes. However, research is pointing to some common factors.

Several health conditions may contribute to increased diabetes rates among people with HS. Among these are heart disease, metabolic disorders, and obesity. These conditions are risk factors for diabetes in all people.^3,5

Doctors have also seen higher rates of diabetes in people with HS who do not have heart disease, metabolic disorders, and obesity. This means something else can cause diabetes to develop in people with HS. Some doctors believe that chronic inflammation, along with diet and lack of exercise, may contribute to higher rates of diabetes in people with HS.^3,5

What can people with HS do to prevent diabetes?

Although people with HS have a higher chance of developing diabetes, you can take action to prevent it. Since HS is an inflammatory disease, efforts to reduce inflammation can slow or even stop the progression of the disease.

The foods and drinks you consume can be a source of inflammation. Certain foods like refined carbohydrates and sugars are highly inflammatory. Other foods like berries, certain vegetables, and olive oil have anti-inflammatory properties.

Making diet changes is one thing people with HS can do to fend off diabetes. Removing inflammatory foods and foods you are allergic or sensitive to can lessen inflammation. Adding anti-inflammatory foods to your diet can also help. The following diets tend to lower inflammation and benefit people with HS:⁶

• Dairy-free
• Mediterranean
• Plant-based
• Sugar-free
• Weight-loss

Excess weight can also cause inflammation in the body. People with HS who are overweight or obese can take steps to lose weight. These may include diet changes like those noted above, as well as exercise.^2,6

People with HS can also take biologics and drugs to lessen inflammation. Doctors may prescribe metformin, which has a history of benefitting people with HS. Metformin helps control blood sugar levels and is commonly used to treat diabetes and prediabetes.^3,5

Living with HS is not easy, but help can come from other people who care and seek to offer support. Doctors dedicated to treating skin diseases can further explain HS and offer guidance on therapies and prevention measures. Lots of doctors are also conducting studies in search of new insights to improve treatments and quality of life for people with HS. Reach out to a doctor who knows about HS and can best assist you. Your doctor can help you create a healthy plan to reduce your risk of diabetes.