Stress and mdi

[Sharrryn]

Hi
I'm suffering severe anxiety and stress at the moment. Am on day 5 of Zoloft antidepressant and side effects aren't nice.
Anyway I'm on mdi and my sugars are high from stress. Been between 12-18 all day. When I was on the pump I'd just do temp basals when I was stressed. Now I just have to keep correcting. I guess there is no other way ??? Any advice.

 

[Diakat]

Check the Zoloft leaflet in case it says there is a risk of higher sugars as a side effect, consider a small change in carb ratio and watch carefully? Otherwise you are doing the right thing by correcting.

 

[Sharrryn]

Check the Zoloft leaflet in case it says there is a risk of higher sugars as a side effect, consider a small change in carb ratio and watch carefully? Otherwise you are doing the right thing by correcting.

Thanks. I couldn't find any info on higher sugars. Some info on the internet says it can lower sugars. I'm on such a small dose anyway to start with I don't think it's the Zoloft itself. I think it's my stress as Zoloft can make you feel more anxious before you start feeling bettter.

 

[Diakat]

Hope you feel better soon. Does the anxiety affect your food choices?

 

[Sharrryn]

Hope you feel better soon. Does the anxiety affect your food choices?

I just have no appetite when I'm anxious. I get nauseous. Just eating plain bland food lately.

 

[kevinfitzgerald]

Hi Sharrryn. I suffer with Generalised Anxiety Disorder (GAD) but I take an Anti D which is actually licensed to be prescribed for GAD and Anxiety Conditions (opposed to depression) It is Duloxetine.. It also doubles up as a treatment for Diabetes Neuropathy which helps and is a bonus. I have noticed no adverse side effects regarding my sugar levels either.

I was at one point prescribed Zoloft (Sertraline) and was on it for 2 years but as you stated it had side effects and I suffered headaches also and being honest I got nothing from it with regard to it being of any help for my anxiety.

Maybe have a chat with your GP. They do not seem to realise that Depression and Anxiety (though linked) are two different conditions. For me Duloxetine takes the edge of my GAD and allows me to get on with things.

Continue though as stated by @Diakat to correct. Your doing things right.

 

[Sharrryn]

Hi Sharrryn. I suffer with Generalised Anxiety Disorder (GAD) but I take an Anti D which is actually licensed to be prescribed for GAD and Anxiety Conditions (opposed to depression) It is Duloxetine.. It also doubles up as a treatment for Diabetes Neuropathy which helps and is a bonus. I have noticed no adverse side effects regarding my sugar levels either.

I was at one point prescribed Zoloft (Sertraline) and was on it for 2 years but as you stated it had side effects and I suffered headaches also and being honest I got nothing from it with regard to it being of any help for my anxiety.

Maybe have a chat with your GP. They do not seem to realise that Depression and Anxiety (though linked) are two different conditions. For me Duloxetine takes the edge of my GAD and allows me to get on with things.

Continue though as stated by @Diakat to correct. Your doing things right.

Thanks for your informative reply. I will definitely look into duloxetine if Zoloft doesn't help.

 

[kitedoc]

When I was prescribed anti-depressants I was told they would take up to 3 weeks to start to work and sometimes the first try didn't work and another type was needed. I took Zoloft in the morning as it causes wakefulness and nightmares if taken at night. Other persons complain or daytime sleepiness and take it at night. It did not seem to affect on blood sugars per se.
Anxiety, stress always puts my blood sugar up and the only way to deal with it was to raise the basal and bolus does of insulin. Stress I was told causes release of extra cortisol in the body. Cortisol is a steroid and it opposes the cation of insulin , meaning that insulin becomes less effective in controlling blood sugars dose for dose than before onset of stress. Also with anxiety adrenaline gets into the act and releases sugar from muscle stores.You would need to discuss altering your insulin with your doctor.
I also found that with stress I would often eat for comfort and that just made things worse sugar-wise.
Purely as an example, (your needs and adjustments may vary a little or a lot from mine) I increased all insulins doses by 20%. any less was pointless in my case of stress. I then went up 10% every second day until things improved sugar-wise. I watched my diet as best I could and used exercise and distraction to help manage blood sugars and stress.
The Really, Really tricky part is knowing when the stress/anxiety effect on my body was abating and when to ease back the insulin doses. usually a hypo or two wold give me the best indication plus progressively lower blood sugars day to day.
As another example, in the week leading up to University exams my total dose of insulin would increase 3 times the usual total. But I had to drop the doses back quick smart within 3 days of the exams all finishing.
I do hope the Zoloft works for you. And you are not the only one, I can understand some of what you are going through. Time heals but it takes its time.!!

 

[Sharrryn]

When I was prescribed anti-depressants I was told they would take up to 3 weeks to start to work and sometimes the first try didn't work and another type was needed. I took Zoloft in the morning as it causes wakefulness and nightmares if taken at night. Other persons complain or daytime sleepiness and take it at night. It did not seem to affect on blood sugars per se.
Anxiety, stress always puts my blood sugar up and the only way to deal with it was to raise the basal and bolus does of insulin. Stress I was told causes release of extra cortisol in the body. Cortisol is a steroid and it opposes the cation of insulin , meaning that insulin becomes less effective in controlling blood sugars dose for dose than before onset of stress. Also with anxiety adrenaline gets into the act and releases sugar from muscle stores.You would need to discuss altering your insulin with your doctor.
I also found that with stress I would often eat for comfort and that just made things worse sugar-wise.
Purely as an example, (your needs and adjustments may vary a little or a lot from mine) I increased all insulins doses by 20%. any less was pointless in my case of stress. I then went up 10% every second day until things improved sugar-wise. I watched my diet as best I could and used exercise and distraction to help manage blood sugars and stress.
The Really, Really tricky part is knowing when the stress/anxiety effect on my body was abating and when to ease back the insulin doses. usually a hypo or two wold give me the best indication plus progressively lower blood sugars day to day.
As another example, in the week leading up to University exams my total dose of insulin would increase 3 times the usual total. But I had to drop the doses back quick smart within 3 days of the exams all finishing.
I do hope the Zoloft works for you. And you are not the only one, I can understand some of what you are going through. Time heals but it takes its time.!!

Thanks for your reply. Yes I'm finding it difficult to know just how much extra to give. I've been trying not to give huge correction doses for fear of crashing later. I've been slowly upping my daily levemir doses also. Stress and blood sugar is a vicious cycle as the more I stress about my high blood sugar the higher it goes. Hopefully things will settle soon.

 

[Brendon.Dean]

What are you eating, are you exercising and what are you stressed about? You don't have to go into great lengths about your stress if you don't feel comfortable but I would like to help you.

 

[kitedoc]

Thanks for your reply. Yes I'm finding it difficult to know just how much extra to give. I've been trying not to give huge correction doses for fear of crashing later. I've been slowly upping my daily levemir doses also. Stress and blood sugar is a vicious cycle as the more I stress about my high blood sugar the higher it goes. Hopefully things will settle soon.

Yep, finger crossed. Your doc and DN are the best person to advise you on insulin adjustments. For me on basal-bolus Novorapid and Levemir it was easier to up the lever 10 to 20% at a time for the morning dose as I could be aware of a hypo easier during the day than the night. After 2 days or so I could up the night time Levemir and watch how the morning sugar was trending. I was working on a ratio of about up to 2/3 total levemir daily dose am and 1/3 pm but it is only a rough rule of thumb. Easing the Novorapid up was trial and error 10 to 20% again choosing the most troublesome after-meal blood sugar first. Toes crossed for you to !

 

[Sharrryn]

What are you eating, are you exercising and what are you stressed about? You don't have to go into great lengths about your stress if you don't feel comfortable but I would like to help you.

Thank you. I just have extreme anxiety. I am always agitated, feel panicky and shaking and crying. I've had type 1 for 35 years and many health complications.... I think my body has just had enough and this is how it reacts. I'm virtually housebound at the moment. I try meditation and distraction to keep busy but it's tough. I stopped using the insulin pump and went back to injections as I had absorption issues and site failures constantly on the pump which also contributed to my stress. I am seeing a psychologist and trying to take it one day at a time at the moment but these antidepressant side effects make it tough.

 

[kitedoc]

Another thought. When i was prescribed Zoloft my doctor checked to ensure my current medications would not interact with Zoloft and caused nasty effects. If you goggle 'Zoloft drug interactions' you could see whether any might clash with Zoloft. If so you need to contact your doctor ASAP. If there do not appear to be any clashes then the usual sudeeffects of Zoloft tool 3 weeks or so to settle for me. Also i was started at 50 mg per day, upped to 100mg after 3 weeks, i recall my doctor saying that starting at 100mg or higher led to stronger sideeffects. Is there a health visitir who could visit you and perhaps coax you outside for a walk etc. Exercise and some social contact can help. Also i have readof people who found that having a pet helped them. Music, comedy on DVDs, reading books (audio) and books from the local library are other activites to consider. Best Wishes.

 

[Brendon.Dean]

Thank you. I just have extreme anxiety. I am always agitated, feel panicky and shaking and crying. I've had type 1 for 35 years and many health complications.... I think my body has just had enough and this is how it reacts. I'm virtually housebound at the moment. I try meditation and distraction to keep busy but it's tough. I stopped using the insulin pump and went back to injections as I had absorption issues and site failures constantly on the pump which also contributed to my stress. I am seeing a psychologist and trying to take it one day at a time at the moment but these antidepressant side effects make it tough.

I can relate to the anxiety, depression, feeling defeated like nothing is working but I am living proof that you can take control of your diabetes, and your body and turn it around and feel good. I believe that you and everyone have the strength and power to live an enjoyable life.

Tell me a little bit about your day to day life, what do you eat, do you exercise, work, etc.. This way I can get a better gauge on whats happening

 

[Sharrryn]

Another thought. When i was prescribed Zoloft my doctor checked to ensure my current medications would not interact with Zoloft and caused nasty effects. If you goggle 'Zoloft drug interactions' you could see whether any might clash with Zoloft. If so you need to contact your doctor ASAP. If there do not appear to be any clashes then the usual sudeeffects of Zoloft tool 3 weeks or so to settle for me. Also i was started at 50 mg per day, upped to 100mg after 3 weeks, i recall my doctor saying that starting at 100mg or higher led to stronger sideeffects. Is there a health visitir who could visit you and perhaps coax you outside for a walk etc. Exercise and some social contact can help. Also i have readof people who found that having a pet helped them. Music, comedy on DVDs, reading books (audio) and books from the local library are other activites to consider. Best Wishes.

Thanks for your support. My doctor did check no known interactions with my other meds - blood pressure and Valium. I'm only on a 12.5mg starting dose of Zoloft so am actually quite surprised by how severe my side effects seem. Probably all part of anxiety anyway. I have great support from family and I have a dog who never leaves my side. If my sugars would just start behaving that in itself would make me feel more at ease. I'll ring my endocrinologist Monday for more advice regarding dose adjustments.
I'm sure it will improve in time. It's just hard to see light at the end of the tunnel at the moment.

 

[Sharrryn]

I can relate to the anxiety, depression, feeling defeated like nothing is working but I am living proof that you can take control of your diabetes, and your body and turn it around and feel good. I believe that you and everyone have the strength and power to live an enjoyable life.

Tell me a little bit about your day to day life, what do you eat, do you exercise, work, etc.. This way I can get a better gauge on whats happening

Hi. I am currently on long service leave. I work in pathology. I love my work but have become so debilitated with anxiety at present I am using my leave until I feel strong enough to go back.
I'm not eating much - Toast , fruit, protein bars. I want to eat more but my sugars seem to skyrocket after eating I find it easier to eat less so as to not to than deal with trying to correct high sugars afterwooods . I've lost quite a bit of weight which I want to put back on as I'm very skinny. I have considered going back on the pump but was finding it too stressful so would rather try and sort the mdi and stress doses first. I go for short works with the dog and to my doctors appointments but am not getting out much otherwise. I just want to get back to my old happy life. Never been on antidepressants before so I am hoping it helps.

 

[Brendon.Dean]

Hi. I am currently on long service leave. I work in pathology. I love my work but have become so debilitated with anxiety at present I am using my leave until I feel strong enough to go back.
I'm not eating much - Toast , fruit, protein bars. I want to eat more but my sugars seem to skyrocket after eating I find it easier to eat less so as to not to than deal with trying to correct high sugars afterwooods . I've lost quite a bit of weight which I want to put back on as I'm very skinny. I have considered going back on the pump but was finding it too stressful so would rather try and sort the mdi and stress doses first. I go for short works with the dog and to my doctors appointments but am not getting out much otherwise. I just want to get back to my old happy life. Never been on antidepressants before so I am hoping it helps.

I'm glad you are trying things and haven't given up!

Ok so to start I think the pump is a very useful tool and when used correctly will give you better control over your diabetes. With that said, the pump alone will not fix your problem because diabetes requires a certain lifestyle. I think it is important that you find the proper pump suited for you and the proper injection site to have your pump. I used OMNI POD on my abdomen the first time around and I had horrible results and despised it. Now I use OMNI POD but on the back of my arms and it works amazing and 99% of the time forget it is there.

As for the the eating problem you are having, this is all a mental battle we have (If I eat less I feel hungry) because we are so used to empty calories with no real nutritional value it takes long to break the habit once you train your body. As a type one we should be eliminating all processed foods so our body can process the food and not spike our sugars so high and for lengthy periods of time. We need to eat smaller portions of natural food every 4 hours and to make sure if these foods have carbs that they are on the LOW GI side. Sweet potatoes, brown rice, blueberries, a good cut of oats, lentils/beans, flax seeds, and hemp seeds, etc. Make sure protein is lean with minimal fat because unlike nut fat it will mess with your blood glucose.

You are living a sedentary lifestyle which imho is 100% the main reason why nothing you are doing is allowing you to control your diabetes and why the high blood sugars is causing anxiety. As a type 1 you are going to have to incorporate high intensity exercises into your day to increase your insulin sensitivity so that your blood glucose will stay and a much more moderate level after the 2 hour post meal spike.

I have personally been down the road of anxiety medication, depression medication and that experience showed me one very important thing. This medication is a bandaid for a problem that has a solution.

I guarantee once you start to change these things and incorporate what I am telling you, that in a week, 2 weeks, 4 weeks you will feel COMPLETELY different, feeling good and radiating once again.

If you have ANY and I mean any questions about this stuff, or want me to be more specific do not hesitate to ask because there is more than hope for you to feel good again, it is a guarantee!

 

[Diakat]

@Brendon.Dean can you really guarantee improvements? Please be careful about making such statements. We are all individuals with different needs/abilities.

 

[kevinfitzgerald]

Hi. I am currently on long service leave. I work in pathology. I love my work but have become so debilitated with anxiety at present I am using my leave until I feel strong enough to go back.
I'm not eating much - Toast , fruit, protein bars. I want to eat more but my sugars seem to skyrocket after eating I find it easier to eat less so as to not to than deal with trying to correct high sugars afterwooods . I've lost quite a bit of weight which I want to put back on as I'm very skinny. I have considered going back on the pump but was finding it too stressful so would rather try and sort the mdi and stress doses first. I go for short works with the dog and to my doctors appointments but am not getting out much otherwise. I just want to get back to my old happy life. Never been on antidepressants before so I am hoping it helps.

Hello Sharyyyn.

Anxiety can be debilitating to point of paralysis.. Not only is mine chronic (GAD) but is at times acute also.

It is so difficult when we have this to contend with on top of also being Type 1..

You stated wanting to get back to your old happy life.. In my experience I sometimes have to force myself into a routine of doing things, even the things that I enjoy and get pleasure from.. Try not to let being Type 1 take over your life. It is just a part of it..

Try to keep things as simple as possible. Fundamentally treatment for Diabetes is Eating foods that work for you, keeping active and taking your insulin (if Type 1) It can be totally overwhelming reading through a lot of threads where it seems you have to have a degree in Quantum Physics and Algebra to understand what people are talking about..

Take each day as it comes, keep notes when things are going well and sugars seem to be on a level but also when things are not so good.. Try to be your own expert on your Type 1 based on your own experiences.. We are all different and there are too many variables in what works for one person to that of another..

Anxiety will always cloud our perspective on things. Anais Nin (Novelist / Writer) quoted "We do not see things as they are, we see them as we are" And when we are riddled with worry everything seems so much worse..

Take things slowly Sharyyyn and chip away a bit at a time and things will improve. Maybe not massively but enough for you to be able to notice when they do.

Start doing things you enjoy even if you have to force yourself.. Our mental and emotional health is equally as important as our physical. We have some control of that, we just need to step back a little and see things as they are and then work on it.. Enjoying ourselves and finding time to relax are an important part of managing this condition and as human beings we all have that right..

Kev

 

[Sharrryn]

I'm glad you are trying things and haven't given up!

Ok so to start I think the pump is a very useful tool and when used correctly will give you better control over your diabetes. With that said, the pump alone will not fix your problem because diabetes requires a certain lifestyle. I think it is important that you find the proper pump suited for you and the proper injection site to have your pump. I used OMNI POD on my abdomen the first time around and I had horrible results and despised it. Now I use OMNI POD but on the back of my arms and it works amazing and 99% of the time forget it is there.

As for the the eating problem you are having, this is all a mental battle we have (If I eat less I feel hungry) because we are so used to empty calories with no real nutritional value it takes long to break the habit once you train your body. As a type one we should be eliminating all processed foods so our body can process the food and not spike our sugars so high and for lengthy periods of time. We need to eat smaller portions of natural food every 4 hours and to make sure if these foods have carbs that they are on the LOW GI side. Sweet potatoes, brown rice, blueberries, a good cut of oats, lentils/beans, flax seeds, and hemp seeds, etc. Make sure protein is lean with minimal fat because unlike nut fat it will mess with your blood glucose.

You are living a sedentary lifestyle which imho is 100% the main reason why nothing you are doing is allowing you to control your diabetes and why the high blood sugars is causing anxiety. As a type 1 you are going to have to incorporate high intensity exercises into your day to increase your insulin sensitivity so that your blood glucose will stay and a much more moderate level after the 2 hour post meal spike.

I have personally been down the road of anxiety medication, depression medication and that experience showed me one very important thing. This medication is a bandaid for a problem that has a solution.

I guarantee once you start to change these things and incorporate what I am telling you, that in a week, 2 weeks, 4 weeks you will feel COMPLETELY different, feeling good and radiating once again.

If you have ANY and I mean any questions about this stuff, or want me to be more specific do not hesitate to ask because there is more than hope for you to feel good again, it is a guarantee!

Thank you