title: A randomised controlled trial of topical glycopyrrolate, the first specific treatment for diabetic gustatory sweating.
abstract: The treatment of gustatory sweating in diabetes mellitus is usually with oral anti-cholinergic drugs, but these frequently lead to unacceptable side effects. Glycopyrrolate is an anti-muscarinic agent that can be applied topically and is efficacious in gustatory sweating occurring in other conditions. In a double-blind placebo-controlled crossover study, we assessed the value of glycopyrrolate in 13 diabetic patients with gustatory sweating. Sweating was measured by a sweat challenge, and diaries recorded by the patients throughout the 2 weeks of each treatment period. Compared to placebo, glycopyrrolate reduced the sweat response to a challenge by 82% (p < 0.01). The frequency of episodes of gustatory sweating during the treatment period was also reduced by 51% (p < 0.01), with a nearly 100% reduction in the frequency of episodes of severe sweating (p < 0.01). In conclusion, topically applied glycopyrrolate is a very effective treatment in reducing both the severity and frequency of diabetic gustatory sweating.
authors.affiliation: Department of Medicine, Manchester Royal Infirmary, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Shaw
authors.forename: C A
authors.initials: CA
authors.lastname: Abbott
authors.forename: K
authors.initials: K
authors.lastname: Tindle
authors.forename: S
authors.initials: S
authors.lastname: Hollis
authors.forename: A J
authors.initials: AJ
authors.lastname: Boulton
mesh_terms: D000287:Administration, Topical; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006024:Glycopyrrolate / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D012119:Respiration; D013547:Sweating, Gustatory / Q000188:drug therapy* / Q000209:etiology
chemical_list: D018727:Muscarinic Antagonists; D010919:Placebos; D006024:Glycopyrrolate