How Are Hidradenitis Suppurativa (HS) and Diabetes Related?

If you have hidradenitis suppurativa (HS), you already know it’s not just “a few bumps.” It’s a chronic, inflammatory skin condition that can hijack comfort,
confidence, and your laundry budget. Now add diabetes (or prediabetes) to the conversation and it can feel like your body scheduled a group project without asking you.
The good news: there’s a real, understandable reason these conditions show up together more often than you’d expectand there are practical ways to lower your risk
and support both conditions at the same time.

This article breaks down the connection between HS and diabetes, what the research suggests, why the link exists, and what you can do with that information
(without turning your life into a full-time medical spreadsheet).

Quick refresher: what HS is (and what it isn’t)

HS is a long-term inflammatory skin disease that typically affects areas where skin rubs togetherlike the underarms, groin, buttocks, and under the breasts.
It often starts with tender lumps that can come and go, and in more advanced cases can lead to tunnels under the skin and scarring.

HS is not contagious, and it’s not caused by “being dirty.” It’s tied to inflammation around hair follicles and a complex mix of genetics,
immune signaling, hormones, friction, and environmental factors.

Quick refresher: what diabetes is (and where insulin resistance fits)

Most of the HS–diabetes discussion centers on type 2 diabetes. Type 2 diabetes usually develops over time, often starting with
insulin resistancewhen the body’s cells don’t respond to insulin as well as they should. Insulin is the hormone that helps move glucose
(sugar) from the bloodstream into cells for energy.

With insulin resistance, the body may produce more insulin to compensate. Over time, blood sugar can rise into the prediabetes range and,
if the trend continues, into type 2 diabetes. Chronic inflammation, excess body fat (especially abdominal fat), inactivity, and genetics can all contribute.

The headline: HS and diabetes are linked in research

Multiple studies have found that people with HS are more likely to have diabetes than people without HS. Some analyses estimate that diabetes is substantially
more common in HS populations, although the exact size of the increased risk varies depending on the study design, the population studied, and which factors
(like body weight) are adjusted for.

Why results vary (and why that’s not a “gotcha”)

Research on real humans is messy (humans insist on being complicated). Some studies compare HS patients to the general population; others match by age/sex;
others adjust for body mass index (BMI), smoking, or socioeconomic factors. When researchers adjust for these, the association can shrinkbut it often doesn’t disappear.

Translation: HS doesn’t “cause” diabetes in a simple one-way line, but HS is associated with metabolic issues (including diabetes and insulin resistance)
often enough that clinicians pay attention to itespecially because HS frequently begins in early adulthood, when people might not otherwise think about diabetes screening.

So what connects HS and diabetes?

Think of HS and type 2 diabetes as two neighbors who don’t share a fence, but do share a set of loud, annoying problems:
inflammation, insulin resistance, and metabolic syndrome.

1) Chronic inflammation can push the body toward insulin resistance

HS is a chronic inflammatory disease. Persistent inflammation can influence how the body handles glucose and insulin. In metabolic research more broadly,
inflammation is closely tied to insulin resistanceone reason chronic inflammatory conditions are often discussed alongside cardiometabolic risk.

HS can involve elevated inflammatory signaling in the body (not just the skin). That systemic inflammatory “background noise” may worsen insulin sensitivity
and metabolic health over time, especially if other risk factors are present.

2) Metabolic syndrome is a frequent “middle step”

Metabolic syndrome is a cluster of risk factors that travel together: elevated blood sugar, high blood pressure, abnormal cholesterol/triglycerides,
and excess abdominal weight. It raises the risk for type 2 diabetes and cardiovascular disease.

HS is often discussed as a condition associated with metabolic syndrome and its components. That matters because metabolic syndrome is essentially a “prequel”
to type 2 diabetes for many peoplelike the trailer you didn’t ask to watch, but the theater insists on showing anyway.

3) Shared risk factors stack the odds

Some factors raise the likelihood of both HS and type 2 diabetes. The big ones:

• Excess weight (especially abdominal fat): can worsen insulin resistance and can increase HS severity via friction, sweat, and inflammatory signaling.
• Smoking: linked to worse HS outcomes and is also associated with metabolic and cardiovascular risk.
• Physical inactivity: can increase insulin resistance; HS pain and flares can make movement harder, creating a frustrating loop.
• Sleep disruption and stress: common in chronic illness and can worsen glucose regulation and appetite hormones.
• Hormonal and metabolic conditions (like PCOS): can overlap with insulin resistance and appear more often in HS populations.

How diabetes can make HS tougher (and vice versa)

How diabetes may affect HS

When blood sugar is frequently elevated, the body’s ability to heal can suffer. High glucose can also increase the risk of infections and complicate skin healing,
which matters for a condition that can involve recurrent, inflamed lesions and skin breakdown.

Some recent research also suggests that HS severity can be higher in people who have diabetes compared with those who do notmeaning the overlap may affect
symptom burden, not just lab numbers.

How HS may increase diabetes risk

HS can contribute to diabetes risk through indirect pathways:

• Inflammation load: chronic inflammation can worsen insulin sensitivity over time.
• Reduced activity: pain, drainage, and friction can make exercise feel like an extreme sport (and not the fun kind).
• Weight changes: less movement plus stress can make weight management harder, and weight gain can worsen insulin resistance.
• Sleep and mood disruption: chronic symptoms can affect sleep and stress hormones, both linked to metabolic health.

Signs it may be time to think about diabetes screening

You don’t need to panic or self-diagnose. But if you have HS, it’s reasonable to ask your clinician whether screening makes senseespecially if you have
other diabetes risk factors.

Common reasons to consider screening

• You have HS plus a family history of type 2 diabetes.
• You have HS plus overweight/obesity or high blood pressure.
• You’ve been told you have high triglycerides, low HDL, or fatty liver disease.
• You had gestational diabetes or prediabetes in the past.
• You notice classic high-blood-sugar symptoms (like unusual thirst or frequent urination).

What screening often includes

Clinicians commonly use tests like A1C (average blood sugar over ~3 months), fasting glucose, or an oral glucose tolerance test depending on the situation.
Many HS-focused discussions also emphasize checking broader cardiometabolic markers (blood pressure, lipids) because the overlap often involves metabolic syndrome.

What helps both HS and metabolic health (without making you miserable)

There’s no single lifestyle change that “cures” HS or magically prevents diabetes. But the overlap between the two conditions means you can pick strategies that pay
double dividendslike buying one ticket and getting two rides.

1) Weight management (if relevant) with a “less pain, more progress” mindset

Weight is a sensitive topic, and it’s not the only factor in either condition. But where excess weight is present, even modest weight loss can improve insulin sensitivity
and may reduce HS flares for some people by lowering friction and inflammatory signaling. The key is sustainability, not punishment.

2) Eat for steadier blood sugar and lower inflammation

Many people do well with patterns similar to a Mediterranean-style approach: more vegetables, legumes, whole grains, nuts, olive oil, and fish; fewer ultra-processed
foods and sugary drinks. This can support weight management and blood sugar stability, and it’s generally a heart-healthy pattern.

HS-specific diet research is still evolving, and triggers can be personal. Some people report flares with high-glycemic foods or certain dairy products.
If you suspect food triggers, consider tracking symptoms briefly and discussing it with a clinician or dietitianespecially if you also have diabetes or prediabetes.

3) Move in a way that doesn’t aggravate HS

Exercise improves insulin sensitivity, but HS can make certain workouts uncomfortable. The workaround is to choose low-friction options:
walking (in moisture-wicking clothing), cycling with appropriate padding, swimming, strength training with breathability, or short “movement snacks” throughout the day.

If underarm or groin involvement is a major issue, your comfort toolkit matters: breathable fabrics, anti-chafe barriers, and adjusting intensity during flares.

4) Quit smoking (a true “if you do one thing…” move)

Smoking is associated with worse HS and is a known risk factor for cardiovascular disease. Quitting can be hard, but it’s one of the most meaningful steps
for long-term health. If you want help, ask about nicotine replacement, medications, or structured cessation programs.

5) Treat HS effectivelybecause inflammation management matters

HS treatments range from topical therapies and antibiotics to hormonal options and biologic medications for more moderate-to-severe disease.
Getting HS under better control can improve quality of life and may reduce systemic inflammation.

Important note: some medications (like systemic steroids) can raise blood sugar, while others have neutral effects. If you have diabetes or prediabetes,
remind your clinician so treatment choices and monitoring can be tailored.

Practical examples: what the connection looks like in real life

Example 1: HS + prediabetes in a 30-something

Someone develops HS in their late 20s, struggles with painful flares, and stops going to the gym because friction and sweating trigger symptoms.
Over a year or two, activity drops, sleep worsens, and weight creeps up. A routine visit shows an A1C in the prediabetes range.
Their care plan focuses on HS control plus gentle movement, a realistic nutrition strategy, and periodic A1C checkspreventing prediabetes from becoming diabetes.

Example 2: Type 2 diabetes complicates healing

Another person has type 2 diabetes that’s been tough to control. Their HS lesions take longer to calm down, and irritation is more likely to linger.
Working with both a dermatologist and a primary care clinician, they adjust medications, tighten glucose management, and develop a skin-care routine that minimizes
friction and infection risk. Better blood sugar control doesn’t “cure” HS, but it can make the day-to-day management less chaotic.

FAQ: quick answers to common questions

Is HS caused by diabetes?

No. HS is a distinct inflammatory skin condition. Diabetes doesn’t “cause” HS, but the two are associated and can share risk factors.

If I control my blood sugar, will my HS go away?

Blood sugar control is great for overall health and may support healing and inflammation management, but HS usually requires its own targeted treatment plan.
Many people benefit from doing both: treating HS directly while supporting metabolic health.

Should everyone with HS get screened for diabetes?

Screening decisions are individualized. Because HS is often associated with metabolic conditions, many clinicians consider screening reasonableespecially if you have
other risk factors (family history, overweight/obesity, high blood pressure, abnormal lipids, history of gestational diabetes, etc.).

Is this link mostly about type 2 diabetes?

Yes, most of the research focuses on insulin resistance, metabolic syndrome, and type 2 diabetes. Type 1 diabetes has a different underlying mechanism.

Conclusion

HS and diabetes are related through a shared web of inflammation, insulin resistance, and overlapping risk factors like metabolic syndrome, weight, smoking, and reduced activity.
The relationship isn’t destinyit’s a heads-up. If you live with HS, it’s worth thinking about metabolic screening and making small, practical changes that support both
skin and blood sugar. Treat HS seriously, support your metabolic health, and enlist a care team that sees the whole picture (not just the “skin part” or the “numbers part”).

Medical disclaimer: This article is for educational purposes and isn’t a substitute for professional medical advice. If you suspect diabetes, have persistent HS symptoms,
or notice worsening lesions, talk with a licensed clinician.

Real-World Experiences: What People Often Notice About HS and Diabetes (Approx. )

People living with HS often describe the condition as “unpredictable,” but the HS–diabetes connection tends to show up in surprisingly consistent ways in daily life.
While everyone’s body is different, these themes come up frequently in patient conversations and clinical settings.

“My flares got worse when my blood sugar was off.”

Some people with both HS and diabetes notice a pattern: when glucose runs high for days or weeks, their skin feels more reactive. They may describe longer-lasting
inflammation, slower improvement after treatment, or areas that stay tender longer than expected. It’s not always a perfect cause-and-effect relationshipHS can flare
for many reasonsbut many people feel that steadier glucose helps their body “cool down” faster.

“Exercise was supposed to help… but exercise made HS miserable.”

A classic frustration is being advised to move more for prediabetes or insulin resistance, while HS makes sweating and friction painful. People often experiment with
a “movement menu”: short walks in breathable clothing, strength training with careful skin protection, or low-friction cardio like swimming. The win isn’t becoming a
marathon runner; it’s finding movement that’s doable even during mild flaresand recognizing that consistency matters more than intensity.

“I didn’t realize HS could be connected to other health issues.”

Many people report that they were treated for HS as a skin-only issue for years. Then a routine checkup revealed high A1C, high triglycerides, or elevated blood pressure.
For some, that discovery is upsettingbut also empowering. It reframes HS as a condition worth managing comprehensively: treating skin symptoms, yes, but also watching
metabolic markers early rather than waiting for a future diagnosis.

“Food triggers felt real, but confusing.”

People often swap stories about dietsome feel better reducing sugary drinks and refined carbs, others notice issues with dairy, and many do best with a whole-food,
balanced approach. The experience can be emotionally loaded because diet advice on the internet is loud and sometimes extreme. A practical strategy people describe as
helpful is short-term tracking: a simple food-and-symptom log for a few weeks, then reviewing it with a clinician or dietitian. That approach can identify patterns
without turning meals into a stress test.

“The biggest improvement came from small changes that stacked.”

A common “aha” moment is realizing that progress rarely comes from one heroic overhaul. People often report better days after stacking manageable changes:
choosing more fiber-rich meals, walking after dinner a few times per week, prioritizing sleep, quitting smoking (or cutting down), and using friction-reducing skin care.
None of these is a magic switch, but together they can improve energy, reduce metabolic risk, and make HS feel less like it’s running the calendar.