November 14, 2007
Daily Care, Mental Health
Question from Stevens Point, Wisconsin, USA:
I have had diabetes for eight years come this December. I know everything I need to do for my diabetes and I’m very logical but, lately, the stress of school (I attend a University) and an onset of anxiety has led me to be stressed out about my diabetes. One time, I got very hypoglycemic and had to eat practically a meal before my blood sugar finally went up. The “low” feeling was horrible and it took forever. Now, I am terrified of going low. I have so much anxiety about it that I tend to overeat or run myself high. I know that running high is not good for my body but, yet, I have this crazy thought that if I go low, I won’t be able to come back up again. I know that sounds crazy, too. I’ve seen my endocrinologist once and she didn’t even give me the time of day. I know what to do, but I don’t want to sound crazy. I’m scared, stressed, and confused, not to mention feeling sick from having high blood sugars. I just need advice on who I can go talk to or who I can see. I’m experiencing a lot of anxiety and stress over my diabetes and it’s leading to poorer control. I’m coming close to 10 years with diabetes and I really don’t want complications. I’m 21 and I have my whole life ahead of me! If anyone can offer me suggestions, I would truly appreciate it.
You are not the first to experience these symptoms as it relates to hypoglycemia and future expectations for glucose control. I think there is a balance to obtain. You cannot live too high and risk complications. You cannot run low and have severe lows that lead to hypoglycemia unawareness. To some degree, you will have to edge back toward better control and not overtreat yourself. I use the analogy of landing a 747 jumbo plane. You want to ease your control back into position. It does not have to be all at once. If the stress and anxiety are getting to you, you may want to seek counseling from a mental health professional until you feel you are back in control.
In terms of therapy, insulin pump therapy has been associated with less hypoglycemia and this may help, if you are not already on an insulin pump. You need to do this in conjunction with your endocrinologist. If you feel this is not resolving, try talking to the nurse or diabetes educator that works with your endocrinologist and see if they have any suggestions. It is okay to address this further. I see it as a big barrier to getting back under control.
Additional comments from Dr. Jill Weissberg-Benchell:
It’s wonderful that you know what’s going on and why you are either eating more than you need to and/or running your numbers high. It’s also wonderful that you realize that knowing what’s going on does not always mean that it’s an easy thing to fix.
Fear of low blood sugars and stress at school are common struggles that people face. It’s too bad that your endocrinologist was not able to help you with this. Are there any nurses or social workers or psychologists that work with the diabetes team? They may be the best ones to help you. Otherwise, contact your local American Diabetes Association office and ask which psychologists or other mental health practitioners they recommend, as it would be great to work with someone who understands diabetes. Once you find someone you’re comfortable with, you will learn strategies to help you manage your fears and stress, and you will feel better.