Diabetes (diabetes mellitus) is a metabolic disorder which affects the body’s ability to regulate blood glucose levels.

The principal hormone involved in this process is insulin, which is produced by beta cells of the pancreas. Insulin regulates blood glucose levels by stimulating cells to use glucose for energy. Insulin also encourages the body to store glucose as glycogen in the cells of the liver, muscle, and fat tissue.

There are 2 types of Diabetes mellitus, both of which are quite different conditions:

Type 1 diabetes (insulin dependent) – This is usually an autoimmune related condition, where the immune system attacks pancreatic beta cells, eventually destroying them. In most cases of type 1 diabetes, the pancreas is unable to produce any insulin, leading to the need for insulin injections.

Type 2 diabetes (non-insulin dependent) – Thisis by far the most common type of diabetes in the UK and worldwide. Type 2 diabetes can develop when cells become less responsive to insulin (insulin resistance), along with an inability to produce enough insulin. It is thought that many people may have type 2 diabetes without knowing! Several factors can increase the risk of developing type 2 diabetes:

  • Being overweight/obesity
  • High cholesterol (low HDL/high LDL)
  • Family history of diabetes
  • Certain ethnic groups (Black, Asian, Hispanic)
  • If you are over the age of 45
  • Metabolic disorders where insulin resistance is a factor, such as polycystic ovarian syndrome.

Diabetes and hair loss, why does it happen?

Hair loss unfortunately can happen with diabetes, and the causes can be varied and complex.

Poor circulation – If blood glucose builds up it can damage organs and blood vessels (especially smaller blood vessels). In time, this can affect oxygen and nutrient supply to the various tissues of the body, including hair follicles.

Hormonal imbalance – Any kind of hormonal imbalance can impact the normal hair cycle, leading to hair loss. Insulin resistance is often associated with hair thinning, especially in those with pre-existing metabolic disorders such as polycystic ovarian syndrome.

Stress – Learning to live with diabetes and manage the condition can be very difficult, especially in the early stages, which can cause a great deal of stress for the sufferer. The physical stress the body experiences can also be a factor,which would be the same for any chronic health condition.

Impaired immunity – Immune health is often affected with diabetes. Sufferers tend to be more susceptible to infection, and wounds can take a lot longer to heal. Infection (especially when accompanied by a prolonged fever) can cause temporary hair loss in some people. Low vitamin D is a common issue for diabetics, especially those with type 1 diabetes.

Thyroid disease – Although it is not clearly understood why,thyroid related issues are common amongst diabetics. Thyroid disease is a well-known cause of hair loss, so it is important to check thyroid function in diabetics on a regular basis.

Medication – All medications can potentially interrupt the normal hair growth cycle to some degree. Some medications used to treat conditions associated with diabetes do come with a higher risk of causing hair loss, such as anticoagulants, statins, antidepressants, and thyroid medication.

Low B12 – A medication calledMetformin is commonly used to treat diabetes, which can reduce B12 absorption in the gut.  

Hair loss for most people with diabetes is usually a temporary problem, some may experience diffuse shedding (above what is normal), others may notice more thinning where the scalp appears more visible. Some people may find their hair grows much slower than it used to, or they may develop a dry and brittle texture. Those with Type 1 diabetes have a higher risk of developing a hair loss condition called Alopecia Areata, which causes a patchy type of hair loss.

What can be done to treat the hair loss?

The cause of hair loss may be directly or indirectly associated with diabetes, or it might be caused by something entirely unrelated! Make sure you get some help from either your GP or a registered Trichologist/dermatologist who can get to the root cause of your issue.

Getting your blood sugar levels under control should be a priority. Make sure to follow the advice of your GP/diabetes specialist and take any medication as directed.

Lifestyle changes

  • Be more active! Exercise will encourage blood flow and improve circulation and will also help with controlling blood glucose levels.
  • Eat a healthy balanced diet. This will help you to achieve a healthier weight (which is key with diabetes management) and prevent any nutrient deficiencies which may be affecting your hair. Low GI (glycaemic index) diets are generally encouraged for diabetics. If you are unsure about what you should and should not be eating, its best to contact your GP first.
  • Managing stress. Getting enough sleep and getting some exercise should help a lot with stress management. Many people like to use meditation, mindfulness, yoga, or just getting some support from friends and family can really help.

Hair loss treatments

  • An appropriate set of blood tests should be done to rule out some of the more common issues associated with diabetes and hair loss. This should include (as a minimum): Complete blood count, Thyroid function, Vitamin D, Ferritin, CRP/ESR. As a Trichologist, I may also ask for some additional tests to be done, when I feel this is warranted based on your individual circumstances and medication.
  • Supplementation will only benefit you if your levels are low/deficient and are suspected to be contributing to your hair loss issue (something your Trichologist/GP will be able to help you with). Blindly supplementing yourself is not a good idea and can actually make the problem worse!
  • Some topical medications may be beneficial for some people but should only be used under the recommendation and guidance of your GP or Trichologist.
  • In the case of Alopecia Areata (AA), isolated patches quite often recover on their own. Sometimes topical/injectable corticosteroids and other medications may be useful in the management of AA.