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Anxiety And Diabetes 205

co-prevalence of symptoms leads to under-diagnosis who don’t. Stress, at a neurochemical level, increas-
and thence, under-treatment of anxiety issues in di- es levels of cortisol in the body, which can make lev-
abetes. What is clear is that anxiety can affect the els of blood sugar rise. Cortisol, in action with other
way people manage their diabetes and, in turn, their hormones, releases a surge of energy in the form of
physical health, like: glucose (sugar), which the body can use to fight or
flee. Thus, management of diabetes becomes a further
- checking blood glucose levels continuously due to problem due to the presence of stress.
intense fears of hypos or developing complications
Anxiety is also seen to rise due to lack of sleep which
- avoiding injecting in public, or not injecting at all, is a commonly reported distress in people suffering
due to worry about what others might think. Among from diabetes. Disturbed sleep patterns add to the
people with diabetes, some have anxiety before burden of anxiety by elevating the abnormal sugar
a diagnosis of diabetes, while for others, anxiety levels in diabetic conditions. The affective states that
may be triggered by specific fears associated an individual experiences as a result of developing and
with managing diabetes (e.g., fear of developing suffering from diabetes include worry, frustration and
complications). Anxiety may be a symptom in pa- feelings of being out of control that may add on to
tients with diabetes and the distress developed the anxiety. Another factor that may load on the anxi-
due to the diabetic condition can aggravate anxi- ety of diabetic individuals is their thought patterns and
ety. Thus, there is a two way connection between thinking styles. Research has shown anxious thinking,
the co-prevalence.
fuzzy thoughts and the worry of symptoms of diabetes
• Common symptoms seen in anxiety and diabe- may enhance the overall anxiety levels in the patients.
tes- Thinking styles among diabetics can further be ex-
plored to outline that their worrisome thoughts about
• Panic, fear, and uneasiness
the ‘right’ food to eat, the fear of development of other
• Sleep problems physiological or medical conditions and their glucose
• Frequent urges to urinate levels can elevate symptoms of anxiety.
• Heart palpitations What is important to differentiate is the condition of
anxiety in diabetes and diabetic distress. With an under-
• Dry Mouth standing of anxiety and diabetes, one must remember
• Nausea that diabetes distress is a commonly prevalent but
hard to nail down condition as it overlaps with several
• Tense muscles related conditions, including depression, anxiety, and
Research literature reveals the prevalence of Gen- stress. They are diabetes-specific emotional state ex-
eralized Anxiety Disorder (GAD) and panic attacks ists. A finding reports that people who were experienc-
among patients with diabetes. Individuals who suffer ing unique emotional issues directly related to the
from panic attacks, for example, are hyper-alert to burdens and worries of living with a chronic disease
signs of impending danger. It is estimated that 14% were said to have diabetes distress. The condition is
of people with diabetes have generalized anxiety characterized by “worry, frustration, concern, and
disorder. As many as 40% of people with diabetes maybe a bit of burnout.
have at least some of the anxiety symptoms and the The prevalence of anxiety disorders in patients with
fear of hypoglycemia is also commonly seen in them. diabetes is found to be higher in female population
Anxiety disorders in people with diabetes may be as- as a result of the neurobiological underpinnings as-
sociated with poor blood sugar control. This can be sociated with the two health conditions.
aggravated by the diet followed by an individual and
the stress that an individual faces on a day to day Diabetes mellitus is a chronic condition with progres-
basis. Sleep patterns, thinking styles and affective sively increasing trends over the years. Prevalence
states are also implicated. of anxiety tends to be higher among this population
group. This adds to the cost, morbidity, and mortali-
Diet, which is full of sugar and fat, does not neces- ty of the prevalent health conditions. Association of
sarily cause anxiety but it does appear to be respon- anxiety with diabetes could be detrimental to the care
sible in worsening anxiety symptoms and impair the of either of these conditions and could worsen the
body’s ability to cope with stress. A study showed prognosis. Monitoring of biochemical parameters like
that people with diabetes who have panic disor- HbA1c and postprandial blood glucose levels and BMI
der have higher HbA1c levels (a measure of blood could be a guide to development of anxiety in these
glucose control over time) in comparison to people

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