HAIR loss is a common problem – almost half of men and women will experience it in their older years.
Age is the most influential risk factor, while genetics are also thought to play a strong role.
But there may be a serious condition underlying your hair loss – diabetes.
The condition affects millions worldwide and needs lifelong management.
It has a number of complications, many deadly, including heart disease, kidney damage, heart attack and stroke, vision problems and cancer.
One of the more subtle symptoms of the condition could be hair loss, said Barbie Cervoni, a registered dietitian and certified diabetes care and education specialist.
She told VeryWell: “Hair loss is often associated with type 1 or type 2 diabetes.
“It is thought that certain problems caused by diabetes may result in hair loss, including an immune system disorder called alopecia areata, poor circulation, and high blood sugar.”
Type 1 diabetes is when the pancreas is unable to produce insulin – the hormone that carries sugar from food to our cells.
Type 2 is when the body doesn’t use insulin properly (insulin resistance), so a larger amount is needed to manage sugar levels.
Barbie said: “Insulin is an important hormone that aids metabolism.
“When it is not being made or used properly, it leads to high blood sugar, which, in turn, can result in numerous serious complications throughout the body if not properly controlled.”
Type 2 diabetes is the more common form of the disease – accounting for between 85 and 95 per cent of all cases, according to Diabetes UK.
Around 13.6million people are at risk of getting it, while a million have no idea they already do, and are undiagnosed.
The NHS says many people have type 2 diabetes for years without realising, because the early symptoms may be hard to spot.
These include thirst, tiredness, weight loss, blurred vision and thrush.
How diabetes causes hair loss
Barbie said people with type 1 diabetes are at increased risk of developing other autoimmune disorders.
“One of the most common is alopecia areata,” she said.
“This occurs when the immune system attacks the hair follicles, leading to patches of hair loss on the scalp and other parts of the body.”
Alopecia areata causes hair to fall out in small patches, potentially leading to whole-scalp hair loss.
It occurs when white blood cells attack the cells in hair follicles, causing them to shrink and dramatically slow down hair production.
Hyperglycemia is another cause of hair loss in diabetes, Barbie said.
Hyperglycemia is when someone with diabetes’ blood sugar levels stay elevated for a long time.
It can occur in people who have undiagnosed diabetes, NHS Inform says.
The persistently high blood sugar can damage tiny blood vessels, disrupting blood flow and nutrients to the hair follicle.
Barbie said: “Hyperglycemia can also cause hair thinning, hair fragility, spareness of hair, or decreased hair growth speed.
“A 2019 study found that type 2 diabetes was associated with an increased risk of severe central scalp hair loss in black women.
“Researchers concluded that black women with type 2 diabetes should be followed closely for central scalp hair loss so that appropriate treatment can be offered.”
Unmanaged high blood sugar levels can also lead to permanent damage to the eyes, nerves in the feet and hands (which can lead to amputations).
The most life-threatening complications are diabetic ketoacidosis, or “diabetic coma”, and severe dehydration.
Barbie said: “Because elevated blood sugar is associated with vascular disruption, poor circulation, and hormonal imbalances, maintaining your blood sugars within your normal range may contribute to preventing hair loss.”
People with diabetes may have episodes of hyperglycemia when triggered by stress, an illness, eating too much, not exercising, and missing medication.
Barbie said: “If your blood sugars are at goal and you are reaching your target numbers that you have created with your healthcare team, yet you are still losing your hair, contact your provider.
“There could be a different medical or nutritional reason as to why you are losing hair.”