Feeling a little worried about hypoglycemia, or low blood sugar, is normal. But some people with diabetes develop severe anxiety symptoms about hypoglycemic 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 hypoglycemia.

Read on to learn more about the connection between diabetes, anxiety, and hypoglycemia and what steps you can take to overcome your symptoms.

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

Reducing blood sugar levels after a meal is important for treating diabetes. But sometimes, your blood sugar can drop a little too low. Low blood sugar is also referred to as hypoglycemia.

Your blood sugar is considered low when it drops below 70 mg/dL. If you have diabetes, you’ll need to check your blood glucose levels often throughout the day, especially when you exercise or skip a meal.

Immediate treatment for hypoglycemia is essential to prevent serious symptoms from developing.

Symptoms of hypoglycemia include:

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

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

  • trouble thinking
  • loss of consciousness
  • seizure
  • coma

To address hypoglycemia, you’ll need to have a small snack consisting of roughly 15 grams of carbohydrates. Examples include:

  • hard candy
  • juice
  • dried fruit

In more severe cases, medical intervention may be needed.

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. When this occurs over a long period of time, it’s referred to as an anxiety disorder.

There are many different types of anxiety disorders, such as:

  • generalized anxiety disorder
  • post-traumatic stress disorder
  • obsessive-compulsive disorder
  • panic disorder
  • social anxiety disorder
  • specific phobias

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

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

Hypoglycemia comes with a range of unpleasant and uncomfortable symptoms.

Once you’ve experienced a hypoglycemic episode, 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 hypoglycemia (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.

Research has shown a strong association between anxiety and diabetes.

A 2008 study found that clinically significant anxiety was 20 percent higher among Americans with diabetes compared to Americans without diabetes.

A diabetes diagnosis can lead to anxiety. You may worry that the disease will require undesirable lifestyle changes or that you’ll lose control over your health.

In addition, the dietary changes, complicated medication, exercise routines, smoking cessation, and blood glucose monitoring associated with diabetes treatment can make anxiety worse.

There are many effective treatment options available for anxiety. If anxiety about hypoglycemia is affecting your day-to-day life, ask your doctor about the following.

Seek education about your hypoglycemic risk

The more you understand your risk of hypoglycemia and the steps you can take to prepare for an episode, the easier it’ll be to manage your fears.

Talk to your doctor about assessing your overall risk. Together, you can develop a plan to prepare for the possibility of a hypoglycemic episode.

You may want to ask your doctor about purchasing a glucagon kit in case of an emergency.

Teach family members and friends how to use the kit if you have a severe low blood sugar episode. 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.

Psychological counseling

Talking with a psychologist or psychiatrist may also help. These healthcare professionals can make a proper diagnosis and provide treatment. This can include medications and cognitive behavioral therapy.

One approach, known as graduated exposure therapy, has been shown to be an effective way to help confront fears and manage anxiety.

Exposure therapy gradually exposes you to the situation you fear in a safe environment.

For example, if you’ve been obsessively checking your blood glucose, a counselor may suggest that you delay checking your blood glucose by one minute. You’d gradually increase this time to 10 minutes or more each day.

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.

Mindfulness

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

If you have diabetes, a little worry about the possibility of hypoglycemia is normal. Experiencing an episode of hypoglycemia can be frightening, so it’s not surprising that recurrent hypoglycemic episodes 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. They can provide further education and recommendations.