Anxiety and Hypoglycaemia

Thursday, 11 June 2020

Feeling a little worried about hypoglycaemia, or low blood glucose, is normal. But some people with diabetes develop anxiety around hypoglycaemic episodes.

The fear can become so intense that it starts to interfere with their daily life, including work or school, family, and relationships. The fear can even interfere with their ability to manage their diabetes properly.

This excessive worry is known as anxiety. Fortunately, there are ways you can manage anxiety surrounding hypoglycaemia.

What is hypoglycaemia?

When you take diabetes medications, such as insulin or medications that increase insulin levels in your body, your blood glucose levels fall.

Reducing blood glucose levels after a meal is important for people living with diabetes. But sometimes, your blood glucose can drop a little too low. Low blood glucose referred to as hypoglycaemia or a hypo, should be treated immediately.

Symptoms of hypoglycaemia include:

  • sweating
  • fast heart rate
  • pale skin
  • blurred vision
  • dizziness
  • headache

If not treated, hypoglycaemia can lead to more serious symptoms, including:

  • trouble thinking
  • loss of consciousness
  • seizure
  • coma

To address hypoglycaemia, you’ll need to have a small snack of carbohydrates. Examples include:

  • jelly beans
  • juice
  • dried fruit

In more severe cases, medical intervention may be needed.

What is anxiety?

Anxiety is the feeling of uneasiness, distress, or dread in response to stressful, dangerous, or unfamiliar situations. Feeling anxious is normal before an important event or if you’re in an unsafe situation. Anxiety that’s unmanageable, excessive, and persists can begin to interfere with your daily life.

Symptoms of anxiety

Symptoms of anxiety can be both emotional and physical. They may include:

  • nervousness
  • inability to manage worrisome thoughts
  • trouble relaxing, restlessness
  • insomnia
  • irritability, trouble concentrating
  • constant fear that something bad may happen
  • muscle tension
  • tightness in the chest
  • upset stomach
  • fast heart rate
  • avoiding certain people, places, or events

Diabetes and anxiety

It’s essential to balance your medications with your food intake to keep your diabetes under control. Not doing this can lead to problems, including hypos.

Because the symptoms of hypos are unpleasant, once you’ve experienced a hypo, you may start to worry about the possibility of future episodes. For some people, this worry and fear can become intense.

This is known as fear of hypoglycaemia (FOH). This is similar to any other phobia, like a fear of heights or snakes. If you have severe FOH, you may become overly cautious or hyperaware about checking your blood glucose levels.

You may also try to maintain your blood glucose levels above the recommended range and worry obsessively about these levels.

Managing anxiety

There are many effective treatment options available for anxiety. If anxiety about hypoglycaemia is affecting your day-to-day life, talk to your doctor or diabetes educator about it. The more you understand your risk of having a hypo the better prepared you’ll be to deal with it.

Teach family members and friends what to look out for and what to do if you are having a severe hypo. Knowing there are others looking out for you can help give you greater peace of mind and reduce your anxiety.

Blood glucose awareness training

Blood Glucose Awareness Training (BGAT) is designed to help people with diabetes understand how insulin, dietary choices, and physical activity levels affect their blood glucose.

This type of training can help you feel more in control of your health and your blood glucose. In turn, it can help keep you from worrying that something will go wrong.

Continuous glucose monitors

If you find that you’re obsessively checking your blood glucose levels, a continuous glucose monitor (CGM) may help.

This device tests glucose levels at routine times during the day, including while you sleep. The CGM sounds an alarm if your glucose levels fall too low.

Physical activity

Physical activity can be very relaxing. Even just a short walk or bike ride can be beneficial to your mental health.

Yoga is a good way to get some exercise while simultaneously calming your mind. There are many types of yoga, and you don’t have to do it every day to notice the benefits.


Instead of ignoring or fighting against your anxiety, it’s better to acknowledge and check in with your symptoms and let them pass.

This doesn’t mean allowing the symptoms to take over you, but rather acknowledge that they are there and that you have control over them. This is referred to as mindfulness.

When you start feeling anxious, try the following:

  • observe your symptoms and emotions
  • acknowledge your feelings and describe them out loud or silently to yourself
  • take a few deep breaths
  • tell yourself that the intense feelings will pass

The takeaway

If you have diabetes, a little worry about the possibility of hypoglycaemia is normal. Experiencing a hypo can be frightening, so it’s not surprising that recurrent hypos can lead to anxiety.

But if the fear affects your daily life or impairs your ability to effectively manage your diabetes, you may have an anxiety disorder.

If this is the case, talk to your doctor or make an appointment to talk to our Psychologist on Call.

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