Anxiety and raised BG

[Jacqui T]

Hi all, I am a new member although I have been a T1 for 23 years. I have recently started using the Libre sensor - which has been fantastic in enabling me to monitor my BG more closely. Today, however, having been nicely in target range for a while, my sugar did a vertical take off! The CO2 alarm went off in the kitchen for no reason and involved calling in various people to sort it out. On my Libre graph, my BG went from a post-breakfast 6.9mmol/L when the alarm went off to 15.7 in less than 2 hours, without any food or drink! I guess it was anxiety - although I didn't realise that it had made me anxious at the time. Has anyone else experienced this and how do you deal with it? I injected 2.5 units of Actrapid and that did the trick but it was pretty scary. Before I started using the Libre, I probably would not have picked this up as I was in the habit of doing finger prick test before meals, before bed and before driving. Also, at other times when I have had a fright or a shock I have gone into hypo... What makes your BG go one way or the other? Thanks for any insight you can give.

 

[Guzzler]

Hello and welcome. The answer could very well be cortisol, one of the 'fight or flight' hormones.

 

[ronialive]

Hello and welcome. The answer could very well be cortisol, one of the 'fight or flight' hormones.

Hi, with the fight and flight response we produce cortisol, adrenalin , noradrenalin and glycogen - all of which make the liver give out its glucose to enable us to runa way. If you think about the Glucagon injections - this is glycogen - it stimulates the liver to release the glucose stored there and then we are instructed to eat as the liver will need to put the glucose back.
This is why stress both causes our blood glucose to rise and then later to fall.
For example I have gne into an exam and interview with blood sugars in the twenty's and come out at 1 or 2. something.
If you know the cause of the anxiety and it is short term they don't recommend injecting as it can result in hypos later - however if long term stress then you have to bring it down but must be aware to keep testing as you will have to eat.

I love my libre - just a shame to be self funding.

 

[Scott-C]

Also, at other times when I have had a fright or a shock I have gone into hypo... What makes your BG go one way or the other? Thanks for any insight you can give.

There's a book on kindle, Sugar Surfing, by Stephen Ponder, which is worth a read. He's T1 and an endo, so has dealt with it both personally and professionally.

The book is about how to use cgm, but there's a bit about what he calls "hollow highs" - spikes caused by adrenalin rushes.

He reckons it's ok to correct them with a few units if it's going to high, but he calls them "hollow" because they're not being pushed by food behind them, so the correction will generally be more modest than with a food high.

It's a bit of a mystery why frights sometimes cause highs and sometimes lows. I suppose it's possible with the loes that we've maybe overbolused for the previous meal and would have had a low anyway.

I've read that in people who've been dx'd for a long time, the alpha cell response, which should release glucagon to tell the liver to release glycogen as glucose to raise bg, becomes blunted due to past hypos. It's part of hypo unawareness.

One of the blokes who drinks in my local is a fireman. He says that he's been in a few incidents where bg is tested in non-Ts and he's seen some crazy lows and highs

 

[kitedoc]

Hi @Jacqui T, As a diabetic and not as professional opinion or advice:
Following on from @ronialive 's excellent answer I think that we can sometimes be hoodwinked about anxiety symptoms and the early symptoms of a hypo. Both sets of symptoms are mediated by adrenaline. at least in part.
It is only by doing a blood sugar level then and there that we might be able to tell them apart for sure. That and perhaps because we have recorded a normal or high normal or elevated BSL just before. Mind you I and others have also experienced hypo symptoms when the BSL is falling rapidly but still at above hypo levels.
Taking in glucose and feeling relief form symptoms might seem to help differentiate between the two but ...
I have experienced definite early symptoms of a hypo (going by the circumstances) and found that by the time I do a finger prick glucose meter reading that the blood sugar has already rebounded to a normal or above normal level due to the adrenaline and glucagon mobilising glucose form liver stores. I still have residual symptoms of a hypo even at normal or above normal BSLs.
And we can tend to feel relieved by eating something because of previous experiences with hypos and so anxiety might be relieved by a similar mechanism.
So I am a little dubious to accept the thought that anxiety per se will lead directly to a hypo - without the symptoms being in fact due to an impending hypo or rapidly falling BSL or there being sufficient insulin on board to blunt the effect of true anxiety on one's BSL.