Fear of hypoglycemia doesn’t have to restrict your diabetes management

Diabetes for me has been a very difficult journey. It doesn’t matter if you’ve had one or twenty low blood sugars, one will kill you, one’s enough. My advice for someone who’s just been diagnosed with diabetes would be to find out as much as you can about your disease.
— Charlene

What is hypoglycemia?

Hypoglycemia is the technical term for blood glucose (sugar) levels that are lower than 4 mmol/L. Hypoglycemia can happen for a number of reasons, including exercising more than usual, not eating on time, eating too little food, drinking alcohol or taking too much diabetes medication. 

Hypoglycemia is more common in people with type 1 diabetes (an autoimmune disease whereby the pancreas stops producing insulin), but it can also happen to people with type 2 diabetes (a condition that occurs when the body does not use insulin properly).

The symptoms of hypoglycemia include: feeling shaky or light-headed; headache or nausea; feeling nervous, irritable or confused; a fast heart rate; and feeling sweaty, weak or drowsy. 


What is fear of hypoglycemia?

Because the symptoms are so distressing – and often occur in the presence of relatives, friends or coworkers, which can be humiliating or embarrassing – many people with diabetes develop a strong fear of hypoglycemia and take any steps necessary to avoid it. 


How does fear of hypoglycemia compromise diabetes management?

People with diabetes might try to avoid hypoglycemia by keeping their blood sugars higher than normal, by not taking insulin or diabetes medications as prescribed. They might also eat more food than they need; they also might restrict their physical activity. All of these things can cause blood sugar levels to remain higher. While these behaviours may prevent hypoglycemic episodes, they can lead to other diabetes-related issues.


Why is it important to control blood sugar levels?

People who continually keep their blood sugar levels higher than normal have an increased risk of diabetes complications, such as eye disease, heart disease, kidney disease and nerve damage. (All of these complications are associated with high blood sugars.) That’s why it’s important that people with diabetes keep their blood sugar levels at the targets specified by their healthcare team.


How can people with diabetes manage their fear of hypoglycemia? 

One of the key coping mechanisms to deal with fear of hypoglycemia is to think about the issue systematically, i.e. what is causing the low blood sugar, and how can it be avoided in the future?

One of the best ways people can figure out why low blood sugars happen frequently is to test their levels regularly and record them in a logbook (most blood glucose meters also record the levels automatically). By doing this, any patterns can be spotted, which can help people and their healthcare teams understand the cause. Once the reason is understood, changes can be made to the diabetes management routine to help prevent lows. 

While fear of hypoglycemia can be a terrifying experience for people with diabetes, proper management of the condition and being prepared to treat low blood sugars quickly are two of the best ways to conquer this fear. 

For more information on hypoglycemia, as well as additional information and resources to help you live well with diabetes, visit Diabetes Care Community.