Low Blood Sugars & Anxiety While Returning to Your Busy Routine
Editor’s Note: This content was made possible with support from Zealand Pharma, makers of Zegalogue®.
Many of us are getting back into the groove of “regular” life after a year of social distancing, quarantining, and working all day from home. While we’re also still being mindful of the ongoing pandemic — and wearing masks in indoor public places — employees are being welcomed back to the office, school is in session, fitness centers are open, and most restaurants are serving indoors again!
Of course, a big change in your daily routine can also really disrupt your diabetes management leading to frequent low blood sugars, blood sugar roller coasters, and more general anxiety and stress. Below, we share some tips and tricks to help you manage some “back to regular life” anxiety.
Low blood sugar basics
First up – learn the low blood sugar basics so you can learn how to best avoid them. Low blood sugar (hypoglycemia) is a blood sugar level below 3.9 mmol/l70 mg/dL. Some people may not feel well or safe at a level below 4.4 mmol/l80 mg/dL. Your goal range should be personalized with support from your healthcare team.
Low blood sugars can be caused by:
- Too much insulin for a meal
- Too much insulin in your bloodstream during physical activity
- Too much background/basal/long-acting insulin
- Skipping meals
Common symptoms of low blood sugars include:
- Lightheadedness or dizziness
- Anxiety or rapid-heartbeat
- Irritability or anger
- Difficulty concentrating or speaking
- …and more
Here, we’ll talk about a few ways to safely prevent or manage low blood sugars while returning to your busy routine.
Reducing your anxiety about low blood sugars
Get an emergency glucagon treatment and tell your friends, family, and coworkers about it!
The potentially scariest possibility is a severe low blood sugar, so it’s important to take care of this one—and get prepared with emergency glucagon—as soon as possible. Severe low blood sugars are lows that leave you unable to eat or drink, and potentially lead to a loss of consciousness or seizures. Today, there are a handful of emergency glucagon treatment options for severe low blood sugars.
Emergency glucagon is critical to treat severe low blood sugars. It works by telling your liver to dump its storage of glucose, raising your blood sugar to a safe level rapidly. While older glucagon treatment kits were complicated and confusing, newer versions make it extremely easy for your friends, family, or coworkers to intervene when you’re experiencing a severe low blood sugar.
These newer glucagon kits can be auto-injected or given nasally (through the nose), making it an easy 1-step process during a likely stressful and scary event. Take some time to teach the people in your life when you might need them to use emergency glucagon on you and how to use it. If you don’t own an emergency glucagon, ask your doctor for a prescription ASAP!
Talk to a diabetes coach or psychologist.
Anxiety is no joke, especially when it comes to diabetes and low blood sugars. Living with diabetes is stressful, even if you’re achieving your goals, it calls for constant attention, energy, and concern. In fact, anxiety is extremely common in those of us with diabetes, whether we’ve lived with it for one year or 20.
Learning how to manage and talk yourself through anxiety related to diabetes isn’t something you have to do alone. Working with a psychologist or diabetes coach who knows real life with diabetes can help you not only manage and reduce your anxiety, it can help you learn new strategies for coping with the overall stress of living with diabetes and the many challenges it can create in day-to-day life. We recommend Lauren Bongiorno, Allison Nimlos, LAMFT, Mark Heyman Ph.D. and his podcast “The Diabetes Psychologist.”
Get a good supply of the right fast-acting carbohydrates.
Fast-acting carbohydrates are foods or drinks that have no dietary fat or protein, which makes it easier for your digestive system to break down into glucose and raise your blood sugar. Most low blood sugars need 10 to 20 grams of fast-acting carbohydrate to return to a safe level about 15 minutes after consuming it. While a banana could certainly raise your blood sugar during a low, it’s not easy to measure, store, or keep in-stock for multiple lows.
When choosing fast-acting carbs for lows, things like glucose tabs, jelly beans, Smarties, Pixie Stix, Skittles, gummies can usually be stored in cold or hot places, can treat multiple lows before you need to replenish the supply, and the carb-count can be easily measured so you don’t over-treat your low. These things are also small in physical size, making it easy to store. You can buy bulk quantities and divide them into bags or buy single-serving packs, making it easy to put them in a variety of places. (Small juice boxes can work well, too, in temperature-controlled storage places!)
Stash fast-acting carbohydrates in all the right places.
Your desk, car, backpack, purse, nightstand, coat pocket, partner’s car, gym bag… and so on! Store a little glucose everywhere you might experience low blood sugars. You cannot be too prepared for a low! Make sure the fast-acting carbs you store do not easily rot, melt, or freeze. (There’s nothing less delicious than a hot, moldy juice box.)
Talk to your doctor about adjusting your insulin doses.
If your at-home routine was more or less active than your at-office routine, you may want to talk to your doctor about adjusting your insulin doses. For example, working from home might mean you get to walk your dog in the middle of the day which might’ve called led to a reduction in your daytime insulin doses. If you’re back in an office and potentially sitting more, you may need a boost in your insulin doses. For some, working from home could mean snacking more (since the kitchen is just 10 feet away) or eating healthier (since you’re not driving past fast-food joints or restaurants). Whatever the change may be, it might call for a change in your insulin doses, too.
Create some consistency in your day — and let your circle help you!
While living with diabetes certainly shouldn’t mean you have to live a regimented schedule every day, creating a little bit of consistency can help a lot. For example, eating roughly the same thing for breakfast or the same combination of macronutrients (fat, carbs, protein) for breakfast can make it easy to keep your blood sugars in your goal range for the first half of your day. Don’t be afraid to explain to your boss that you need to eat lunch at the same time every day or ask your family to help you adjust certain aspects of your diabetes regimen. By making at least one meal a little routine, you can reduce the amount of mental energy you have to give to your blood sugar for a good chunk of the workday.
Low blood sugars are a tedious, stressful, and sometimes very scary part of living with diabetes. The more we can prepare and fine-tune things to prevent lows altogether, the safer we will be!