**7. Effects of hyperglycemia on thermoregulation during thermal stress**

Hyperglycemia can have an important negative impact on body core temperature regulation. Specifically, hyperglycemia can lead to increases in Posm which have been independently associated with impairments in sweating and SkBF as described in the earlier section [79]. Furthermore, hyperglycemia can induce dehydration through osmotic diuresis [80] which can lead to hypovolemia without adequate fluid replacement. Recently, studies have demonstrated that the combination of hyper osmolality and hypovolemia augments any effects to further exacerbate impairments in heat dissipation in healthy individuals [81, 82]. In contrast, acute hyperglycemia (induced by hyperinsulinemic-hyperglycemic clamp) did not result in the impairment of NO-mediated skin microvascular function [83].
