How to Deal with Complications Anxiety

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marilyn-ritholz

Marilyn Ritholz, Ph.D. Senior Psychologist at the Joslin Diabetes Center

The idea of developing complications can be a huge source of stress and anxiety for people with diabetes. The seemingly looming threats of eye disease, heart disease, kidney disease, and nerve damage can be overwhelming. But careful management of blood sugars can keep some of these complications at bay.

“The general fear is that complications will come and there is nothing you can do about it,” said Marilyn Ritholz, Ph.D. Senior Psychologist at the Joslin Diabetes Center. “The most important thing people should realize is that they could delay the onset and stop the progression of diabetes complications .” According to a groundbreaking study conducted by the Diabetes Control and Complications Trial, “keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney, and nerve damage caused by diabetes.” The study was conducted  from 1983 to 1993 and is funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

“That [study] absolutely revolutionized diabetes care,” said Dr. Ritholz. “This led to the intensive diabetes care with more frequent glucose monitoring and more frequent insulin administration. People realized they could do something about their complications by keeping their blood glucose levels as close to the normal range as possible.”

The ways to maintain optimal blood glucose levels have been well documented among diabetes professionals and include: checking blood glucose as often as possible, taking prescribed insulin and oral medications,  exercising regularly,  and eating foods with low amounts of carbohydrates, among other lifestyle choices.

But for many patients, maintaining tight control of blood glucose can be scary and can lead to fear of hypoglycemia. Dr. Ritholz said people will sometimes keep their glucose higher than they should because they are worried about their blood sugar dropping too low or developing hypoglycemia, which can lead to some of the following symptoms:  shakiness, nervousness or anxiety sweating, irritability, confusion, blurred/impaired vision, tingling or numbness in the lips or tongue, headaches, weakness or fatigue, anger, stubbornness, or sadness. .

“Sometimes, people may mistake high levels of anxiety for symptoms of hypoglycemia. Therefore, it is important to check your glucose level to see whether or not you actually have a low blood sugar, less than 70 mg/dl.

Further, anxiety is not uncommon with diabetes.  As mentioned previously, people are anxious about developing complications. They may have heard horror stories about foot or even leg amputations, which can occur from the complication of neuropathy.  But amputations have drastically declined over the past 20 years, and tighter glycemia may account for this decline. .

If you are concerned about complications, you should tell your doctor that you want to dedicate some time during your next appointment to discussing diabetes complications and prevention methods. Try and make sure your doctor is answering all of your questions fully. If going over all aspects of diabetes management during your appointment gets overwhelming, be sure to let your doctor know that you want to understand more about complications and that the most positive ways he can discuss diabetes complications with you will be helpful.

2 Responses to How to Deal with Complications Anxiety

  1. Great info. I work with parents of children with diabetes and they frequently worry about complications developing in their child. Good tips on helping them know thanks to the DCCT that the risk of complications can be prevented.

  2. Tom says:

    I have to say I thought this article was awful and its purpose seems to be just to be content for content’s sake rather than actual assistance. Based on the title, I came expecting insight into anxiety in a diabetes context, and all the article does is list every possible complication (as if people who are anxious about them aren’t aware of them already?) and give broad non-specific unscientific advice to keep your blood sugars as normal as possible. People with diabetes who are nervous about complications (let alone the higher bar of anxiety) I would think are well aware that maintaining normal blood glucose is their best bet to avoid complications. The level of analysis here seems like an undergraduate level exam answer, not specialist analysis. Essentially it’s not helpful and I would say even harmful to people seriously dealing with anxiety, particularly based on the way the article is being pitched on other platforms. I would have expected a much higher standard from this organisation based on its reputation and a more patient-focussed and considered approach.

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