Hypo Anxiety and Worry

[gab_07]

Hi everyone,

I'm 21 and have had T1 since I was 12, and started on an Omnipod pump in March 2016.

I've had absolutely perfect hba1c's all of the time until the last couple of times- where it has been in the orange zone. I can definitely put this down to severe anxiety over hypos.

So typically I'm giving less bolus' on purpose, over eating most of the time (in particular, massively over treating hypos) and letting myself run on the high side. I'm finding myself feeling really anxious after most bolus' I give... And obviously the feelings of anxiety and hypoglycaemia (at least for me) are annoyingly similar.

I recently read this article: http://www.diabetes.co.uk/emotions/anxiety-over-hypoglycemia.html which has made me feel less alone in this, and given some advice.

I was just wondering if anyone has any tips or advice on this, or if anyone is experiencing anything similar?

Thanks!

Gabrielle


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[azure]

Have you always had this anxiety or did it start recently @gab_07 ?

If it developed recently, do you know what the cause might be?

 

[gab_07]

Have you always had this anxiety or did it start recently @gab_07 ?

If it developed recently, do you know what the cause might be?

Hi,

I guess when I was younger I felt so oblivious to everything (my mum was helping) and I really don't remember having any worries or problems at all. I had a moderate/severe hypo nearly 4 years ago, but I feel like that didn't spark this either.

I have just finished 3 years at uni living both alone and with my boyfriend... I feel as though the most likely thing to be playing a part in the anxiety is the 'insulin on board IOB' feature that comes on the Omnipod.

For example... If my bg is 3.0, and my pump is telling me that I have 2U on board (2U would bring it down by 6 for instance)... I really really freak out because in my stupid head, that would leave my bg at absolute rock bottom, so I would over eat massively.

I also don't have a DSN that will reply to me much at all. I have no confidence to properly adjust basal rates, ratios etc to see what works for me. I lost touch with my DSN a week after getting the pump. I'm soon hoping to transfer to the hospital where I am now living, and hope that a DSN can contact me frequently in the beginning just to build my confidence.


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[azure]

I think any life change like leaving uni can make any anxiety about diabetes worse. I know when I've had changes in my life, I do start worrying about all aspects of diabetes whereas normally those anxieties are just normal and very mild.

I think getting a good DSN will help a lot as they'll provide reassurance as well as practical help and advice.

I have a pump but I don't use the Insulin On Board feature. I do however test frequently and have learnt what works for me as regards food and insulin. I suggest sticking to 'safe' meals that you're confident bolusing for; testing frequently including a nighttime check if that will help reassure you; and not eating your evening meal too late.

Get a breakfast and lunch that work for you (you can vary them later) and stick to known evening meals.

You may also want to do a basal test to make sure that's right.

You mentioned having a BS of 3. If this happened to me two hours after eating I'd just top up with a small amount of carbs and perhaps try the same meal the next day with slightly less bolus.

Try to gently and slowly reduce your sugars. It's better to go slowly and feel happier than rush things. Correct hypos with glucose tablets so you have a measured amount and don't go overboard.

(Edited to add that this is just my experience re IOB. My DSN agreed it wasn't necessary to use it as I'd managed perfectly well without that feature on my old pump. He also said it was largely to avoid over-correcting. Speak to your DSN if you have any concerns with IOB or other pump issues)

 

[slip]

Hi @gab_07 - Do you get good warning signs of going low?

I don't use a pump but I assume the IOB is a measure of whats left of your bolus(I have IOB on my BG meter), if your bolus carb ratio is right and your carb counting is correct, in theory(!) you shouldn't end up with figures you've mentioned. but if you do, as azure has said treat with glucotabs and remember 10g carbs would increase BG by ~2-3mmol (usually) so if 2u on board would drop you 6, you would need 4 or 5 glucotabs (~20g carbs) to keep you on the level, 6 or 7 would take you up to ~5mmol. Small, timely amounts of quick acting carbs easily at hand will help, and if you're worried you're low, have the carbs first at the first warning sign and then test - nothing worse than thinking you're low, fiddling with a testing kit to confirm, fumbling the test strips with the shakes and then find out your BG is 1.6 just before you become a jabbering heap on the floor.

Having the confidence to know when you're low and knowing you can easily do something about it will help.

I'm also surprised you 'lost touch with my DSN a week after getting the pump' - maybe that's when the doubt and anxiety crept in? Give them a ring now, and just politely remind them who you are and that you need some help!

 

[abigailsheree]

Hi
I'm 24 and have the same problem after I had 4 hypos where I needed help from others and ended in a&e with stitches in my lip that's all in 1 year and I now freak out when my sugars are below 4. I found the best comfort making sure I have plenty of supplies and personally I text someone in my family but why not speak to someone like a diabetes nurse who will be able to give you advise and also give you support


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[1abRat]

I think your anxiety is possibly being increased by the loss of control. Your pump is a wonderful tool but it might have left you feeling less directly in control.

You need to take back your feeling of empowerment somehow. I would recommend a couple of books that will hopefully make you feel a bit more confident again, they're fairly easy reading.

Think like a Pancreas https://www.amazon.co.uk/Think-Like...9016058&sr=1-1&keywords=think+like+a+pancreas

Pumping Insulin https://www.amazon.co.uk/Pumping-In...id=1469016076&sr=1-1&keywords=pumping+insulin

Another think might be to see if you can get hold of a Freestyle Libre sensor. The sensor costs ~ £50 + £5 P&P and if you have a phone with NFC you don't need to buy a reader as your phone can read the sensor.

This will allow you to check your glucose at-a-glance for two weeks. You will be able to get an idea of what your sugars are doing when you glance and see whether your glucose is just slowly trickling down or if it's going down fast and you'll need to act more quickly or if your meal bolus kicked in a bit fast but now your meal has caught up and its rising again.

I'd recommend the books initially though as the huge amount of data from the Libre can be overwhelming at first.

Your Diabetes clinic should have some sort of counselling service available - it might be worth enquiring about?

 

[noblehead]

I recently read this article: http://www.diabetes.co.uk/emotions/anxiety-over-hypoglycemia.html which has made me feel less alone in this, and given some advice.

Just read it and it really is a good article.

Anyone who uses insulin will fear hypo's, that is only natural @gab_07 but we shouldn't let this fear rule our lives and the advice towards the end of the article (and from the posters above) is all good.

Like @1abRat I'd highly recommend the book Pumping Insulin to help you get back on track with your pump and bg control. Good luck.

 

[gab_07]

Thank you to you all for the nice messages and advice! Will take all of the tips etc on board!


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[gab_07]

Hi @gab_07 - Do you get good warning signs of going low?

I don't use a pump but I assume the IOB is a measure of whats left of your bolus(I have IOB on my BG meter), if your bolus carb ratio is right and your carb counting is correct, in theory(!) you shouldn't end up with figures you've mentioned. but if you do, as azure has said treat with glucotabs and remember 10g carbs would increase BG by ~2-3mmol (usually) so if 2u on board would drop you 6, you would need 4 or 5 glucotabs (~20g carbs) to keep you on the level, 6 or 7 would take you up to ~5mmol. Small, timely amounts of quick acting carbs easily at hand will help, and if you're worried you're low, have the carbs first at the first warning sign and then test - nothing worse than thinking you're low, fiddling with a testing kit to confirm, fumbling the test strips with the shakes and then find out your BG is 1.6 just before you become a jabbering heap on the floor.

Having the confidence to know when you're low and knowing you can easily do something about it will help.

I'm also surprised you 'lost touch with my DSN a week after getting the pump' - maybe that's when the doubt and anxiety crept in? Give them a ring now, and just politely remind them who you are and that you need some help!

I've never really lost hypo awareness... But when my blood goes below 3 for example, I will just feel mentally different (maybe dizzy) and the physical shakes and weakness isn't there.

The problem is the difficulty differentiating between anxiety feelings and hypo feelings. I always always carry more than enough hypo supplies on me everywhere I go.

I feel I just have too much info/problems to explain to a DSN over email or phone...ill try to collate it somehow.

Thank you so much though!


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