Balancing Blood Sugar Anxieties: Do you fear high or low?

May 18, 2021

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES

The mythical land of living life with diabetes in the “normal” range of 70-120 is just that: mythical. No matter what type of diabetes you have, it is nearly impossible, with the tools we have today, to maintain blood sugars in the target range 100% of the time. While our goals as people with diabetes may be similar, they are personalized, nuanced, and influenced by a number of different factors.

As a mother of young children, avoiding severe lows is one of my main goals in my diabetes self-management. When I was pregnant, I was living life in the 60 mg/dL range for a lot of the first trimester and definitely was less aggressive with my low treatments in an attempt to achieve the very strict targets of pregnancy. This ended up causing a lot of scary lows and was really difficult to keep up my food intake to stave off the lows due to my pregnancy-induced nausea.

Living with diabetes for years also causes many of us to have our own anxieties and fears related to our blood sugars. Many people with diabetes struggle with fear of low blood sugars, and sometimes this causes a negative impact on people with diabetes.1 Severe low blood sugars can lead to seizures in the short term, but are not shown to have long term negative effects on people with diabetes as once was thought.1

What about people who have diabetes who are more anxious about the long-term complications related to high blood sugars? I know I’ve met many people who keep their blood sugars on the low end for most of their day without feeling anxiety.

Researchers in California recently published an article titled, “’Hyperglycemia aversiveness:’ Investigating an overlooked problem among adults with type 1 diabetes.”2 They surveyed 219 adults with type 1 diabetes who wear Dexcom continuous glucose monitors (CGMs) and found that among the participants, 36 (16.4%) felt that they preferred having hypoglycemia to hyperglycemia.2 The participants who were more avoidant of high blood sugars had a higher percent time in range, a lower percent in time above range, but a higher time below range.2

The hyper-averse participants also tend to treat their blood sugar at lower thresholds than the participants who are less hyper-averse.2 There were no differences with regards to diabetes-specific distress or mental well-being between the group of hyper-averse and not hyper-averse.2 The researchers go on to say that more research should be done, in a broader group of people with type 1 diabetes, to get more information on the safety of staying in the lower range.2

No matter where you land on the spectrum of blood sugar concerns, there’s no doubt that when you have diabetes, or love someone who has diabetes, there are added anxieties. We hope you have an opportunity to connect with other people with diabetes so you can share your experiences and feel supported in your diabetes journey.

  1. Fear of Hypoglycemia in Children and Adolescents and Their Parents with Type 1 Diabetes
  2. “Hyperglycemia aversiveness”: Investigating an overlooked problem among adults with type 1 diabetes