Anxiety And BG Don't Mix

This was originally posted to my blog, Odyssey.

I’ve been back to work now for just about two-and-a-half months. I spent four years not working due to serious health issues. It’s been a real adjustment for me, I’ll tell you what.

Just returning to work, period, was anxiety inducing and exhausting. I went from waking up naturally almost every morning and going to bed naturally every night to having to go to bed and wake up on a schedule. Although I had a natural daily routine, I now had to make adjustments and get used to a fixed, unnatural (to me) routine. I mean, really, who in their right mind enjoys waking up to an alarm? Good thing I thrive fairly well on routine…even if I thrive better on variety in some areas of life. Still, I’d much rather be free!

The positive of going back to work is multifaceted. For one, I have a set work schedule and not a random one, that’s awesome. I work with my hubby. We don’t actually work side-by-side or anything, but we have the same job and work in the same building. We sometimes even get to have breaks and lunch together! As if we didn’t have enough to talk about and do together before, now we have more time together AND more to talk about. And we can totally relate to eachother’s stresses and work experiences. :slight_smile:

Another positive of being back to work is feeling like I have more worth. Mostly more self-worth, but also more worth to others. When I wasn’t working I did everything I could to be a useful part of the household and to feel like I wasn’t just some body sucking up oxygen. I cleaned the house, took care of the pets, prepared meals, and anything else I could do to ‘earn my keep’. But I always felt useless and worthless for the most part. Now I bring in a paycheck again, money is always nice. My job is customer service, and it’s helping others in a fairly important way. I wont say where I work, but it’s a worthy job, for the most part. The job requires me to know a lot, a whole lot. I have a lot of resources to help me, but it’s still stressful just thinking about everything I need to know and understand in order to help the people who come to me looking for guidance and answers. It’s stressful but brings me a sense of value. I enjoy helping others, even if it’s in some small manner. It feels good, man.

The stress level is what has done the damage here. I had my BGs mostly in a pretty good range, then I started working and they shot through the roof and have since refused to come down. I eat mostly the same as I did before, although we do give in to the fast food after work monster sometimes. My exercise level is the same as well. I make sure to drink plenty of water throughout the day, no need to get dehydrated on top of high BG. I’ve raised my basal insulin a bit at certain parts of the day. Nothing seems to be working, they just won’t come down. The only thing that is different is my anxiety level. I was hoping it’d calm down once I got settled into the new environment, routine, learned the job, etc., but it hasn’t. I have social anxiety and a mild case of agoraphobia and they make my job stressful since this job is customer service! I handle it well, I’ve been getting songs of praise from my bosses, but the stress is there, hidden within me, all the time. It shows in my sky high BGs.

My BGs are in the 300’s from around about 1 PM until 10 AM every single day. They are only in the normal range between 10ish AM until 1ish PM. This is kind of strange since I work 8:30 AM - 5:30 PM. I usually eat a whopping 55-100 grams of carb throughout the day (unless it’s a day we end up eating out for dinner, which we try not to do very often) with protein and fat for energy (LCHF). The eating out days make me end up in the 400’s rather than 300’s, but that’s the only difference.

Can anxiety really do this much to BG?

I’m on Metformin (2K per day) and pump Humalog. I am type 1 and also have PCOS and hypothyroidism which both make BG control even more difficult.

Even my correction boluses aren’t doing much… I’ve even changed my set locations to see if maybe I’ve used the same spots too often and built up scar tissue. Nothing helps.

How do I fix this? Do I just raise my basal to an outrageously high amount? I know, I know, if I need it, I need it. But I was raised with the belief more insulin is bad, you should control BG by other means first, then more insulin if needed. I’m still stuck in that mindset, which isn’t all bad, but it’s the resistance to taking more insulin that hurts me here. There’s no bringing the anxiety down, I already use every healthy coping mechanism I know. The anxiety will always be there. So how do I bring down the BGs? I’m so screwed up in the head, I really, really, really do not want to have to take yet more insulin, but I already eat pretty low carb and get as much exercise as I can handle… what more can I do?

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Have you asked your endo about this? Are you already using what would be considered high based on the average insulin/weight ratios ?

What if you try just a little more insulin, and see if there is a small trend down. Then continue to increase if that is making a difference.

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I take about the norm for my weight. It wouldn’t be a big deal to take more, but it’s all in my head and the bad things I was told about insulin growing up (“insulin is bad for you” “You should aim to take less!” “Insulin makes you fat!” “If you take more insulin you are a bad diabetic”) I know they’re not true, but it stuck with me in a bad way and now I have issues about my relationship with insulin. I do plan to raise my basal in increments, I just need to actually do it. :frowning:

So do it! Spending hours in the 300 and 400s is doing damage to your body. Much more damage than a little more insulin could ever do. Correct! And adjust your basal! BTW, anxiety can and does affect BGs. But not to drive them up to 300 and 400.

The voices in my head that spoke louder, said "high BGs result in higher risk of complications!

@Tamra11 I am not walking in your shoes. But from where I stand and based on my personal experiences, I feel that you can not effectively help others if you won’t help yourself, and it sounds like you would like to. I also speak from personal experience when I say that cognitively when I run 300+ whether short term or long term I am not nearly as effective as when my BGs are in range. I make many more mistakes and errors in judgement when I am High or Low. I have gotten “used to” high BGs in the past, and thought “I can just deal”. Might be true in the short term, but not the long if your experience becomes similar to mine. I feel like I have a mental fog and I am just slogging through the day when I am high. My productivity can be so bad that my employer sends me home to deal with my “hangover” because he doesn’t understand.

Insulin is life. Use it as you need to survive to your fullest. The attitudes that many of us heard when growing up were based on the science of the time, common misconceptions, and witchcraft. I personally use what I need when I need. My T1 neighbor at times shakes his head and tells me I use too much insulin. To which I reply that might be true for you, but not for me now. Our differences are what unite us. We all respond differently but in a similar manner. Sort of how stereotypes get formed.

Yes, Insulin does have the potential to make us fat. Why is that? Is it because we know we can take a larger dose to compensate for overeating, and so that becomes a habit? Or is it an uneducated stereotype based on diabetics who had weight challenges to begin with and also use insulin? I’m not a DR, I am sure there are many logical explanations that I will never understand… I do know that weight is a challenge for me. I count every carb. Could I eat less every day? Yes. Will I? Someday. For now 70 carbs/day is where I’m at. Based on my exercise level, stress level, eating schedule, body size, etc… that means roughly 67-70 units/day for me as basal/bolus combined. I could lose a few, which I am …slowly, comfortably without doing anything drastic, because quick changes send my BG skyward. 2 years ago, I used almost 160 units combined.

I hope you find a release for all the stress you are enduring. Stress will (it’s a fact) put your BGs through the roof. I have been there. It’s not fun and there often seems like there is no way out at the time. The timing of your BG spikes would seem to be a direct correlation to your new job. Is there a way to work off-site doing your CS work? I assume you are in a cube-farm? Is there a cube slightly further away from the others, or an unused office out of the way that might help to lower your stress? Is there someone at work that you are able to confide in about your agoraphobia and can help if needed? The change in daily routine/environment can make your BGs out of whack (it certainly does for me) until you get acclimated to the new schedule.