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Fear of too low blood sugar

Low blood sugar or hypoglycaemia is a common concern for a person with diabetes treated with insulin, and their loved ones.

If you use insulin, your blood sugar level may drop too low because insulin products work in a formulaic way, and they do not always sufficiently meet the body’s varying daily need for insulin. Minor, easily self-treatable drops in the blood sugar level are common in insulin therapy. However, if they become a recurring theme, it may be necessary to review the therapy and possibly make changes to it.

The risk of too low blood sugar levels is low in the drug treatment of type 2 diabetes.

New insulin products with a lower risk of exposure to low blood sugar levels as well as therapy technology, such as sensors and insulin pumps, have significantly reduced the risk of serious hypoglycaemia. Still, the fear of hypoglycaemia is very common.

There are individual differences in how different people experience low blood sugar levels. In its mildest form, the experience is unpleasant but, in the worst-case scenario, it can be scary and life-threatening. When it comes to too low blood sugar levels, the physical sensations may be reminiscent of the reactions caused by fear.

Fear of hypoglycemia

Things you may find frightening about too low blood sugar levels include the symptoms, a loss of control, its effect on your behaviour, other people’s attitudes, having to rely on the help of others or, for instance, the thought of having an accident or losing your driving licence as a result of it. The fear of hypoglycaemia may also be linked to fear of death. Sometimes, just one particularly bad previous experience with a too low blood sugar may leave you traumatised and fearing a repeat. The fear of hypoglycaemia may also be the result of witnessing or hearing about someone else’s experience with a severe hypoglycaemia.

It is only natural to be afraid of too low blood sugar levels, and it is important to be aware of the possibility of it and anticipate situations where the blood sugar level can easily drop. However, sometimes, the fear of hypoglycaemia may overburden and limit your life. The fear is harmful if it starts to interfere with or dominate your life, for example, in the form of constantly checking your blood sugar. It may undermine self-management, for instance, if it results in you keeping your blood sugar constantly too high or reducing your physical activity. If a loved one of the person with diabetes has a fear of hypoglycaemia, it may also sometimes have an adverse effect on care.

Where can I get help for my fear?

The fear may be alleviated by facts about the way your system works in the case of low blood sugar levels and learning to anticipate situations where your blood sugar can drop too low. If you have fear of hypoglycaemia, you may find it beneficial to train for situations which may expose you to too low blood sugars, such as physical exercise, in a safe environment.

Glucose sensing, and the related low blood sugar alert, helps to identify situations with a risk of exposure to hylow blood sugars and increases the sense of security. A smart pump, which pauses the insulin dose when your blood sugar level drops alarmingly low, may be helpful.

If needed, consultation with a professional therapist or even medication may help overcome the fear.

Updated 30.9.2023