Diabetes as a potential cause for anxiety, and other underlying factors explored.
In the complex world of health, two conditions have emerged as leading causes of disability in developed countries: diabetes and anxiety. Both conditions, while seemingly unrelated, share a surprising connection that affects millions of individuals worldwide.
Diabetes, a metabolic disorder characterised by high blood sugar levels, requires constant monitoring and management. For those with type 1 diabetes, the ongoing demands of testing blood glucose, managing insulin doses, and the fear of complications can lead to increased stress and anxiety. This continuous self-management can be mentally exhausting, creating a vicious cycle that further exacerbates anxiety levels.
Anxiety, on the other hand, is defined as "excessive worry or fear at real or imagined situations." Research suggests that people with diabetes face a higher likelihood of experiencing anxiety compared to the general population, with studies indicating that anxiety affects about 48% of people with diabetes, significantly higher than the prevalence in the U.S. population (18.1%).
The link between diabetes and anxiety is not solely psychological. Physiological factors also play a significant role. Anxiety and depression can disrupt the hypothalamus-pituitary-adrenal (HPA) axis, leading to hormonal imbalances that worsen glucose tolerance and increase insulin resistance. This, in turn, can increase anxiety, creating a vicious cycle.
Studies have also found positive correlations between anxiety levels and markers of poor glycemic control such as HbA1c and fasting blood glucose (FBG). This suggests that higher blood sugar levels are linked with increased anxiety.
The emotional challenges of living with diabetes can also contribute to anxiety. Fear of complications, diabetes burnout, stigma, and fear of needles are major contributors to anxiety among people with diabetes. Burnout in particular can lead to interruptions in diabetes management, further worsening mental health and glycemic control.
Anxiety and diabetes also share symptoms such as rapid heartbeat, sweating, and feelings of weakness or dizziness. Hypoglycemia, or low blood sugar, is a risk for people with diabetes and shares some symptoms with anxiety.
Effective diabetes management can be challenging and stressful, potentially triggering episodes of anxiety. A diabetes treatment plan should include nutrition guidelines, monitoring practices, medication use, weight loss tips, activity goals, and emotional support systems.
Treatment options for anxiety include individual counselling, group therapy, cognitive behavioral therapy, medication, lifestyle changes, and complementary and alternative healthcare practices like yoga and meditation. Diagnosing anxiety requires a person to see their doctor and may involve filling a questionnaire about psychological and physical symptoms, referral for mental health screening, or detailed assessment by a mental health professional.
In the United States, anxiety affects nearly 40 million adults, and diabetes affects about 34.2 million U.S. adults. The association between diabetes and anxiety develops through a complex interplay of physiological, psychological, and behavioral factors. Comprehensive diabetes care that includes psychological support and addressing lifestyle factors is important to break this cycle.
[1] American Diabetes Association. (2018). Diabetes and Mental Health. Accessed from https://www.diabetes.org/healthy-living/mental-health/mental-health-and-diabetes [2] National Institute of Mental Health. (2021). Anxiety Disorders. Accessed from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml [3] International Diabetes Federation. (2019). Diabetes Attitudes, Wishes and Needs Study (DAWN5). Accessed from https://www.diabetesatlas.org/knowledge/dawn-study [4] American Psychological Association. (2019). Stress in America: Diabetes. Accessed from https://www.apa.org/news/press/releases/2019/07/stress-diabetes [5] Diabetes Care. (2018). Psychological Distress and Glycemic Control in Adults With Type 2 Diabetes. Accessed from https://care.diabetesjournals.org/content/41/10/2178
- The ongoing demands of managing type 1 diabetes, including monitoring blood glucose levels and managing insulin doses, can lead to increased stress and anxiety.
- Anxiety, a condition characterized by excessive worry or fear, affects about 48% of people with diabetes, significantly higher than the prevalence in the general population (18.1%).
- Anxiety and depression can disrupt the hypothalamus-pituitary-adrenal (HPA) axis, leading to hormonal imbalances that worsen glucose tolerance and increase insulin resistance.
- Studies have found positive correlations between anxiety levels and markers of poor glycemic control such as HbA1c and fasting blood glucose (FBG), suggesting that higher blood sugar levels are linked with increased anxiety.
- The emotional challenges of living with diabetes, such as fear of complications, stigma, and fear of needles, are major contributors to anxiety among people with diabetes.
- Hypoglycemia, or low blood sugar, is a risk for people with diabetes and shares some symptoms with anxiety, such as rapid heartbeat, sweating, and feelings of weakness or dizziness.
- Effective diabetes management requires a comprehensive approach that includes nutrition guidelines, monitoring practices, medication use, weight loss tips, activity goals, emotional support systems, and mental health treatment options such as counseling, therapy, meditation, and yoga.
