Dear Counselor’s Corner,
I’m so afraid of severe hypoglycemia, I let my blood sugars run high. How can I get over this fear?
If you are taking insulin and working to keep your blood sugar close to your target range, you are probably going to have low blood sugars sometimes. Low blood sugar can be scary and some people who have a fear of low blood sugar keep their blood sugar high in order to avoid lows. Fear of low blood sugar can also cause people to avoid activities that they think may make their blood sugar go low, like exercise, or where they think that treating a low could be challenging, like driving. Fear of lows can not only keep people’s blood sugar high, making them not feel well and putting them at higher risk for diabetes-related complications, but it can also have an impact on a person’s quality of life. Fear of hypoglycemia can also affect your relationships with others…including your spouse or partner.
People who have a fear hypoglycemia generally fall into a couple of different categories: people who have a fear of hypoglycemia because they have had a severe low in the past, and people who have never had a severe low, but worry that they might.
If you have ever had a severe low, then it makes sense that you would have anxiety about having another one. The first thing I would suggest is to look and see if there is a reason why this low happened. Did you take insulin when you started eating dinner and then got distracted and didn’t finish all your food? Or did you go for a long run that day and forgot to set a temp basal on your pump? Trying to understand why something happened, based on facts, can help you in a couple of ways. First, it can help you not do the same thing again. And second, it can help you put your fear in context. Fears tend to generalize, and if you can’t identify which situations are safe, and which are not, everything becomes dangerous and scary.
If you have a fear of low blood sugar, but have never had a severe low, you may keep your blood sugar high because you are worried that you won’t be able to treat a low blood sugar if you do have one, either because you won’t have enough low supplies or you won’t be able to think straight. In this situation, try bringing your blood sugar down a little bit at a time to show yourself that you can do it. For example, if you are anxious to have a blood sugar below 200mg/dl, try bringing it down to 180mg/dl before treating. A couple days later, bring it down to 160mg/dl. And eventually, bring it down, and keep your blood sugar in your target range. This will help you see that you can handle lower blood sugars and give you confidence that you can treat them. And eventually when you go low, you’ll be able to pop some glucose tabs and see you’ll come right back up without thinking twice.
If you have a fear of lows that’s really affecting your life, and that you’re having trouble dealing with on your own, you may want to seek treatment from a mental health provider with expertise in diabetes.
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I am so glad to read an article like this. I was the person who would rather keep the sugars high and not deal with a low. I used to have lows in my sleep for a length of time equal to over 8-9 months in a year and a half. So I was up at night and slept in the day when it made sense that it something happened my neighbors could hear me scream and help versus at 3-5 am and no one responds. I started drinking the Ensure high protein before bed and that helped but I was always afraid until realizing that my PCP was giving me too much insulin for a setting. Now on a pump I put in what 20units equaled to and I was shocked and surprised to know it was to cover 150 carbs. I never ate that much and no wonder I was always low. Thank you so much this I’m sure will help people.
Thank you so much for your comment, Tania, and we’re glad you were able to adjust your settings and find what works for you.
I also have had nerve-shattering lows in the past but since being diagnosed with celiac disease 2+ years ago it doesn’t happen. I also notice that I seem more sensitive to when I get in the 90s and below and my BG no longer plummets and responds faster to glucose tabs.
Interesting, Karen – thank you for sharing!
Have you considered trying keto or super low carb? I’ve been type 1 for over 30 years and my last year on keto has been the best of my life. No highs and only super duper rare lows that I always see coming.
are there any comments on the reverse of this? a very tight target range and trying to avoid highs that sometimes causes more lows than ideal.
That’s a very good question and we’re going to have our diabetes psychologists answer this in our November newsletter. Stay tuned!
I am so frightened of this pleade help.
Dr. Mark Heyman, who also lives with type 1 diabetes, is a psychologist who specializes in helping people with the challenges of living with diabetes. He gives some very good tips on understanding and moving beyond hypoglycemia fears in this article, but you may also want to speak with your provider or a psychologist like Dr. Heyman to give you more personalized support.
I was diagnosed in 2018 type 3c.
I am terrified of lows as I live on my own. It’s making me really ill now running very high sugars for over 14 months.
I’ve been suicidal and no one is helping me..
I’m not living anymore, I’m just existing.
I just can’t stop sleeping.
I’m not going to live long.
I need help.
It sounds like you are having a really hard time. Please email me directly and I’ll see if I can help. firstname.lastname@example.org
Dr. Edelman is a phenomenal listener who assists many and cares for all. I truly hope you receive all the love and comfort you need to continue on this great journey that is life.
You are valued, and your ideas are important.
You deserve to be happy!
I don’t have much will or strength left..
I’ve been terribly neglected.
But thanks for your kind words
There is a wonderful psychologist practicing out of San Diego named Mark Heyman. He lives with type 1 so he understands the challenges personally, and he runs the Center for Diabetes and Mental Health. Please consider reaching out to him – here is his website and contact information: https://cdmh.org/start-here/
Sadly I’m in the U.K. and don’t have the finances.
Thank you anyway x
Have you heard of this diabetes helpline in the UK? They may be able to provide assistance or ideas for support where you live: