Anxiety - side effect or cause?

[Chris12345]

Hi All

I am about 6 months into my journey; now on 2g of SR metformin along with 5mg of linagliptin. All gradually uptitrated, none of the usual side effects, and linagliptin only for the last month as I was suffering from post prandial spikes. I have also massively cut carbs as per usual advice on here (HFLC etc), and maintain an exercise routine of weights and running 5-10km a couple of times a week. Not overweight, in fact I've been told not to lose any more weight which is hard (I'm 5'11 and weigh 73kg). LADA originally suspected, but so far ruled out by the GAD and C Peptide tests (but being repeated soon as specialist nurse still says I dont add up).

Anyway, the drugs / diet / exercise routine seems to be working in terms of blood sugar readings both self monitoring and HC1 (now around pre-diabetes level).

The problem I was hoping for a little advice on is that I seem to be VERY sensitive to stressors now, and feel a little anxious more often. I have read that anxiety can cause the fight or flight response, and raise levels. I experienced this after a stressful week when my readings were going up as high as 10 even before meals. I've also read that linagliptin can increase anxiety, which would be a strange visious circle if one of the factors affecting my personal management is a sensitive reaction to stress. Perhaps a little chicken and egg.

Another example is that through monitoring I have learnt the foods I can tolerate. Sometimes however I can spike up after eating a smaller portion of a food I am normally fine on if I am feeling a little stressed (not even necessarily a lot of stress, which is not sustainable with a job as a little stress is natural but having it wipe me out with post hyper fatigue is not great). So I am thinking stress/anxiety is something I need to try and manage alongside diet and exercise.

The other thing I have found is that I am tired a lot of the time now. A lot like the kind of tiredness I felt when Hyperglycemic (foggy/glued up thinking with a strong desire to sleep), although my self monitoring readings have been normal when I check (6/7).

Any ideas, suggestions or requests for clarification most welcome!

 

[xfieldok]

Stress will definitely raise your bgl. Are there any Mindful Courses near you. Not tried it myself but others here have found it useful.

 

[Chris12345]

Im giving mindfulness a go, you're not the first to mention this so good suggestion. I've got a paid subscription on Headspace app which I'm trying to get into.

 

[NicoleC1971]

If you do manage the headspace practice or something else that takes you out of yourself for a while, then you may find your appetite improves such that you can hold onto your remaining fat supplies. I did not try hard enough with HeadSpce but do find a walk with a good book in my ears or Radio 4 Shipping Forecast if I awake sleepless in the small hours are great. Ditto pilates or any exercise done at a slow and focussed pace work well too.
I think at this stage of diagnosis it is understandable that you might be preoccupied with thoughts about blood sugars and food choices plus the diagnosis.
Whether you are LADA or type 2 you seem to be doing a good job helping out our pancreas. You are doing all you can and will do even better when you've mastered relaxing!

 

[Chris12345]

Thanks Nicole

 

[mansingh01]

Hi All

I am about 6 months into my journey; now on 2g of SR metformin along with 5mg of linagliptin. All gradually uptitrated, none of the usual side effects, and linagliptin only for the last month as I was suffering from post prandial spikes. I have also massively cut carbs as per usual advice on here (HFLC etc), and maintain an exercise routine of weights and running 5-10km a couple of times a week. Not overweight, in fact I've been told not to lose any more weight which is hard (I'm 5'11 and weigh 73kg). LADA originally suspected, but so far ruled out by the GAD and C Peptide tests (but being repeated soon as specialist nurse still says I dont add up).

Anyway, the drugs / diet / exercise routine seems to be working in terms of blood sugar readings both self monitoring and HC1 (now around pre-diabetes level).

The problem I was hoping for a little advice on is that I seem to be VERY sensitive to stressors now, and feel a little anxious more often. I have read that anxiety can cause the fight or flight response, and raise levels. I experienced this after a stressful week when my readings were going up as high as 10 even before meals. I've also read that linagliptin can increase anxiety, which would be a strange visious circle if one of the factors affecting my personal management is a sensitive reaction to stress. Perhaps a little chicken and egg.

Another example is that through monitoring I have learnt the foods I can tolerate. Sometimes however I can spike up after eating a smaller portion of a food I am normally fine on if I am feeling a little stressed (not even necessarily a lot of stress, which is not sustainable with a job as a little stress is natural but having it wipe me out with post hyper fatigue is not great). So I am thinking stress/anxiety is something I need to try and manage alongside diet and exercise.

The other thing I have found is that I am tired a lot of the time now. A lot like the kind of tiredness I felt when Hyperglycemic (foggy/glued up thinking with a strong desire to sleep), although my self monitoring readings have been normal when I check (6/7).

Any ideas, suggestions or requests for clarification most welcome!

Hi- reduce carbs - check out the diet doctor website - great for low carbs meals

 

[Member496333]

If you do manage the headspace practice or something else that takes you out of yourself for a while, then you may find your appetite improves such that you can hold onto your remaining fat supplies. I did not try hard enough with HeadSpce but do find a walk with a good book in my ears or Radio 4 Shipping Forecast if I awake sleepless in the small hours are great.

I eventually grew tired of Headspace. It’s a great resource for teaching the benefits of meditation, but after a while it began to feel a bit like a money-making ploy. That’s fine, of course. They’re a business and need to grow, but for me personally something just wasn’t clicking anymore. I felt like I was being exploited into paying for something that I could now do alone. I still meditate, but I either roll commando or listen to a free podcast to help set the mood.

All that said, I have Headspace to thank for enlightening me, so I’m not knocking it, but I’m happy that I’ve let it slip by the wayside. It’s great for beginners but I don’t think it needs to be a lifelong commitment unless you’re addicted to apps that collect data and offer rewards. Kind of seems contrary to the whole ethos of mindfulness.

 

[jjraak]

Hi @Chris12345

Just read up on your posts

so here's my resume..

T2 aug 2018...worked hard to get into safer areas blood wise

suffered the false hypos, sweaty, feeling rough, off kilter, sometime i felt the need to go sit down.
a spot of sweet stuff, coke or chocolate sorted that, all before i knew i was T2 and those were not good for me.
But the dark chocolate worked, so that was my Go to now..( no longer suffer the issue, but it did persist well in to my Dx period i think it was jan/feb 2019 that i had the last one. ).

Well i, got to safety july 2019 HBA1c down from 57 at dx to 40...yippee..
life was better..except i had this nagging thought ..i just wasn't really 'ME' anymore.

Can't describe it as anything else but i felt broken..not shattered beyond repair..just 'different'
in how i related to things worldwide and close to home.
missus dislikes that phrase, so i tried to explain, it's like a mirror that's cracked..
you can still use it, but the reflections just not the same.

Once we had that conversation and she saw how much it bothered me, she started to spot the signs as well.

I LOVED watching the news..grew up with a dad glued to it, so i followed suit.
But now i found it stressed me out..no real reason..anything..even the weather.
people, situation, some i would never been in all started to make my mind whirr.

I am mindful that it's just TOO easy to point everything and anything at T2
so i began to wonder if i had ANOTHER issue, a more 'mental' one.

It got to the stage i sought help..(had pooh poohed the idea for decades, yet here i was asking for it.)

8 sessions with a private counsellor..( the expected back track through my life to find any causes)
.but the counselling, while opening up some scars that i thought had healed, proved that they hadn't ..so i had to address them in some way, but i didn't find my 'cause 'of the anxiety.

(i had gone into the counselling, with what i had identified as a possible cause that may have been the issue., but the sessions didn't solve it or even identify it as such)

But i gave it a good go.

NHS then got in touch (private was almost immediate, NHS was months later)
went to sessions where it was purely focused on CBT..cognitive behaviour therapy.

I found that more helpful, personally.

basically a mental gym..so when i got anxious i should assess why, when not anxious if it was a real situation or a hypothetical situation..all things i guess we should know, and i probably did, deep down..
but ti was the HCP putting it into a training plan that switched on all the lights in the recesses of my mind.

Id say DO look up and maybe ask for a little counselling..as said it's busy,... so dates maybe months away.

read up on CBT, try the mindfulness, the apps work i believe..(not tried).

If it helps books are out there..(obv do research some are more suited then others)
IF you have a kindle..scoot over to Hotdeals uk..where they do an extensive range of free or 99p book offers..wide range many on this subject...need to check and deals do stop early..but at the cost of just downloading, what ya got to lose..?

Found this one still on offer as an example.

Not recommending, simply pointing out the options that i found out there, ..before delving in too deep maybe.
read one & do some research.

the CBT worked for me, in that i get less anxiety, now i am able to rational and put into place some of the ideas i learned,
but i still feel 'Broken' in some ways..most would never know, because thanks to that help, i just cope so much better.

btw, not everyone will get you can have 'issues' that they don''t get.
a bit like T2D conversation, around the foods we avoid and why

so it may be a lonely voyage, but like T2D, you may need to make it, to get to a place YOU find healthier.

good luck, sorry for the long post.

Hope some of it helps in some small way.

 

[Lamont D]

Before diagnosis and every so often now and then (work related), I suffered with anxiety, it is a well known symptom of reactive hypoglycaemia, which is the condition I have.
My condition is a direct hormonal response glucose/insulin imbalance to food.
I spike really quickly, and then my pancreas produces too much insulin. I then go hypo. Unless I very low carb.
I am not saying that you have anything like this.
But anxiety is a side effect of blood glucose levels rising and dropping quickly.
If you are experiencing fluctuating blood glucose levels, because of your T2. You could be still eating too many carbs.
I also take a Gliptin, and I'm going to research if one of the side effects is anxiety.

 

[Chris12345]

Thank you, what you says makes a lot of sense and picks up on the more 'holistic' angles I was trying to get my head around. Trying to treat and manage my diabetes is a big part of it all, but not the whole story; we are complicated machines and there is other stuff going on as well which all acts together. I'll certainly investigate the CBT and that great place for some new Kindle books as well

Hi @Chris12345

Just read up on your posts

so here's my resume..

T2 aug 2018...worked hard to get into safer areas blood wise

suffered the false hypos, sweaty, feeling rough, off kilter, sometime i felt the need to go sit down.
a spot of sweet stuff, coke or chocolate sorted that, all before i knew i was T2 and those were not good for me.
But the dark chocolate worked, so that was my Go to now..( no longer suffer the issue, but it did persist well in to my Dx period i think it was jan/feb 2019 that i had the last one. ).

Well i, got to safety july 2019 HBA1c down from 57 at dx to 40...yippee..
life was better..except i had this nagging thought ..i just wasn't really 'ME' anymore.

Can't describe it as anything else but i felt broken..not shattered beyond repair..just 'different'
in how i related to things worldwide and close to home.
missus dislikes that phrase, so i tried to explain, it's like a mirror that's cracked..
you can still use it, but the reflections just not the same.

Once we had that conversation and she saw how much it bothered me, she started to spot the signs as well.

I LOVED watching the news..grew up with a dad glued to it, so i followed suit.
But now i found it stressed me out..no real reason..anything..even the weather.
people, situation, some i would never been in all started to make my mind whirr.

I am mindful that it's just TOO easy to point everything and anything at T2
so i began to wonder if i had ANOTHER issue, a more 'mental' one.

It got to the stage i sought help..(had pooh poohed the idea for decades, yet here i was asking for it.)

8 sessions with a private counsellor..( the expected back track through my life to find any causes)
.but the counselling, while opening up some scars that i thought had healed, proved that they hadn't ..so i had to address them in some way, but i didn't find my 'cause 'of the anxiety.

(i had gone into the counselling, with what i had identified as a possible cause that may have been the issue., but the sessions didn't solve it or even identify it as such)

But i gave it a good go.

NHS then got in touch (private was almost immediate, NHS was months later)
went to sessions where it was purely focused on CBT..cognitive behaviour therapy.

I found that more helpful, personally.

basically a mental gym..so when i got anxious i should assess why, when not anxious if it was a real situation or a hypothetical situation..all things i guess we should know, and i probably did, deep down..
but ti was the HCP putting it into a training plan that switched on all the lights in the recesses of my mind.

Id say DO look up and maybe ask for a little counselling..as said it's busy,... so dates maybe months away.

read up on CBT, try the mindfulness, the apps work i believe..(not tried).

If it helps books are out there..(obv do research some are more suited then others)
IF you have a kindle..scoot over to Hotdeals uk..where they do an extensive range of free or 99p book offers..wide range many on this subject...need to check and deals do stop early..but at the cost of just downloading, what ya got to lose..?

Found this one still on offer as an example.

Not recommending, simply pointing out the options that i found out there, ..before delving in too deep maybe.
read one & do some research.

the CBT worked for me, in that i get less anxiety, now i am able to rational and put into place some of the ideas i learned,
but i still feel 'Broken' in some ways..most would never know, because thanks to that help, i just cope so much better.

btw, not everyone will get you can have 'issues' that they don''t get.
a bit like T2D conversation, around the foods we avoid and why

so it may be a lonely voyage, but like T2D, you may need to make it, to get to a place YOU find healthier.

good luck, sorry for the long post.

Hope some of it helps in some small way.

 

[Chris12345]

That's really interesting... especially the part about changes in BG possibly causing anxiety. Because of a number of factors, including intense exercise now and then, I do fluctuate quite a bit. Especially trying to match food intake to energy expenditure so I dont keep losing weight. I am not often in high ranges any more, but there is still variance. I'll have a think. As always, many roads lead to carbs... the dreaded kryptonite!

Before diagnosis and every so often now and then (work related), I suffered with anxiety, it is a well known symptom of reactive hypoglycaemia, which is the condition I have.
My condition is a direct hormonal response glucose/insulin imbalance to food.
I spike really quickly, and then my pancreas produces too much insulin. I then go hypo. Unless I very low carb.
I am not saying that you have anything like this.
But anxiety is a side effect of blood glucose levels rising and dropping quickly.
If you are experiencing fluctuating blood glucose levels, because of your T2. You could be still eating too many carbs.
I also take a Gliptin, and I'm going to research if one of the side effects is anxiety.

 

[Chris12345]

PS, not listed on all sites, but both fatigue (which is also an occasional problem) and anxiety are listed as side effects of Trajenta (the gliptin I take). Only been on it a month, and it seems to be working so loath to stop yet. Also as above, it may not be the problem.

Before diagnosis and every so often now and then (work related), I suffered with anxiety, it is a well known symptom of reactive hypoglycaemia, which is the condition I have.
My condition is a direct hormonal response glucose/insulin imbalance to food.
I spike really quickly, and then my pancreas produces too much insulin. I then go hypo. Unless I very low carb.
I am not saying that you have anything like this.
But anxiety is a side effect of blood glucose levels rising and dropping quickly.
If you are experiencing fluctuating blood glucose levels, because of your T2. You could be still eating too many carbs.
I also take a Gliptin, and I'm going to research if one of the side effects is anxiety.

 

[Lamont D]

PS, not listed on all sites, but both fatigue (which is also an occasional problem) and anxiety are listed as side effects of Trajenta (the gliptin I take). Only been on it a month, and it seems to be working so loath to stop yet. Also as above, it may not be the problem.

I couldn't find that in my gliptins side effects leaflet or on anything I could find on the websites especially the manufacturers description online.

 

[Chris12345]

Yes, it's strange. Found listed in a few places but not universally.

https://www.drugs.com/sfx/tradjenta-side-effects.html

I couldn't find that in my gliptins side effects leaflet or on anything I could find on the websites especially the manufacturers description online.