Is there a link between Type 2 diabetes and anxiety?

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Living with Type 2 diabetes isn’t always easy. From carb counting to blood glucose monitoring, there is a lot to think about.

It is no wonder, then, that some people with the condition may experience anxiety disorders more commonly than the general population.

But there are lots of things you can do to help manage your anxiety levels. It is also important to remember that everyone feels anxious sometimes – whether they have diabetes or not. It is a normal part of life.

Does Type 2 diabetes cause anxiety?

Anxiety is not a symptom of Type 2 diabetes. But people living with diabetes can be more at risk of struggling with anxiety and depression than the general population.

Living with diabetes can be overwhelming. There is so much to do and to remember that lots of people find it difficult to cope at times.

In fact, up to 40% of people with diabetes say they have struggled with their psychological wellbeing at some point.

What is anxiety?

Anxiety is a natural part of the body’s fight or flight response. It kicks in when we are faced with a physical or emotional threat.

When we feel under threat, our body releases stress hormones. These make our heartbeat and breathing faster, increase our blood pressure, and release nutrients into the blood. All this is designed to make sure our organs and limbs have all the blood and energy they need to either fight the threat or run away from it.

Anxiety is the body’s response to this process, which all happens in seconds. People might recognise anxiety as a feeling of distress, unease or dread that keeps them alert and aware.

The symptoms include:

• feeling nervous
• worrying
• finding it difficult to relax
• finding it difficult to concentrate
• feeling very restless
• feeling irritable
• a feeling that something terrible is about to happen

Anxiety can also affect us physically:

• muscle tension
• fast heartbeat
• chest tightness
• upset tummy

What is an anxiety disorder?

For most of us, anxiety is useful and will go away by itself after the threat has passed. Sometimes, however, these feelings can last for a long time and get in the way of everyday life.

Healthcare professionals usually call this an anxiety disorder.

The most common types of anxiety disorder are:

• generalised anxiety disorder: worrying about lots of different things intensely and excessively every day
• social anxiety disorder: an intense, excessive fear of being judged by other people. This often results in people avoiding social situations
• panic disorder: recurrent, unpredictable, severe panic attacks
• phobia: an intense and irrational fear of a specific object or situation, such as spiders or needles

Lots of people with anxiety may have panic attacks or sudden surges of intense fear. The symptoms vary from person to person, but they often include:

• quick heartbeat
• shortness of breath
• dizziness
• feeling sick
• sweating
• shaking
• dry mouth
• feeling detached

How is Type 2 diabetes linked to anxiety?

People with diabetes face stressful situations all the time. The fear of having a hypo, for example, can make someone feel anxious. This kind of short-term anxiety is normal, and it will usually pass quite quickly. Sometimes, though, these feelings carry on and interfere with everyday life.

Doctors do not know why people with diabetes are more likely to develop anxiety disorder. They think it may be linked to the stress of living with the condition.

Managing Type 2 diabetes can make some people anxious, for others, the anxiety is unrelated to their diabetes.

According to Diabetes UK, one in five people with Type 2 diabetes, who use insulin, and one in six, who do not, experience moderate to severe anxiety symptoms.

Dealing with anxiety can impact on how people manage their Type 2 diabetes. They might stop doing their exercises, smoke, drink alcohol, or turn to comfort foods, for example.

All this can impact on blood glucose levels and increase the risk of diabetes complications in the long run.

Can sugar levels cause anxiety?

Researchers are not sure about the link between blood glucose levels and anxiety yet. Some studies have shown that stress can raise blood sugar and others concluded that it lowers levels. Either way, it appears that stress and anxiety lead to the change in glucose levels, not the other way round.

It is important to know that some of the symptoms of hypoglycaemia, such as trembling and sweating, are similar to those of anxiety.

People who find it difficult to tell the difference should check their blood glucose to be sure.

How can I reduce the impact of anxiety?

Some simple ways to help overcome anxiety include:

• talk about it: share your feelings with someone you can trust. It might be a friend, family member, healthcare professional, or a fellow member of a peer support group
• stay active: physical activity can make you feel better. Find something you like doing – it might be cycling, dancing, or gardening – and try to do it every day. Remember to start small and build it up from there
• get plenty of sleep: getting enough sleep can help you feel calm and relaxed. Try going to bed and getting up at the same time every day and making sure the room is quiet and dark. Building a relaxing bedtime routine, such as having a warm bath or reading before going to sleep, can also help
• avoid unhealthy coping mechanisms: some people turn to alcohol or drugs to cope with feelings of anxiety. But they are just a short-term fix. In the long term, these coping mechanisms are likely to make people even more anxious. They will also negativity impact on your diabetes management

When should I tell my healthcare team?

People with diabetes who find that anxiety is getting in the way of their everyday life should speak to their diabetes doctor or nurse.

They can provide medical advice and talk about treatments for anxiety. They may also refer the person to a specialist who can offer some tips on coping.