Low blood sugar and anxiety are linked, but the relationship is complicated.
Symptoms of low blood sugar can mirror anxiety’s symptoms, or worsen existing anxiety.
Shakiness,fast heart rate, irritability, nausea, difficulty concentrating, and panic are all shared symptoms.
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Some people, especially those who have diabetes, may also experience anxiety about regulating their blood sugar levels.
Fear about becoming hypoglycemic and anxiety related to diabetes management are real.
You’ll also discover other ways diabetes and anxiety overlap and tips on managing these conditions.
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Low blood sugar triggers when a person’s blood glucose falls below normal levels.
For a person without diabetes, low blood sugar is considered to be below 55 mg/dL.
Without checking blood sugar levels, it may be difficult to differentiate between the two states.
If your glucose levels are normal, then low blood sugar is not causing the symptoms.
There is a shared physiological base for the two conditions.
When low blood sugar occurs, the body attempts to normalize levels by bringing blood glucose up.
Increased epinephrine levels, however, trigger a “fight-or-flight” response in the body.
This same biochemical process is also linked to anxiety.
While this may help raise and normalize blood sugar levels, higher cortisol levels are also linked to anxiety.
Can Low Blood Sugar Cause Anxiety Attacks?
Technically, it’s not low blood sugar itself that causes anxiety attacks.
It’s the body’s response to low blood sugar, namely epinephrine.
This hormone is what makes you feel anxious.
It also causes other symptoms when you have low blood sugar.
Among them are racing heart, sweating, and tingling.
If your blood sugar stays low long enough, the hormone cortisol will also contribute to feelings of anxiety.
The combined effects of epinephrine and cortisol could be interpreted as a panic attack.
Low blood sugar panic attack symptoms may include:
Who Gets Low Blood Sugar?
People With Diabetes
Low blood sugar is most commonly discussed in the context of diabetes.
People withdiabeteshave difficulty regulating blood sugar, due to issues with insulin production or utilization.
They may experience abnormallyhigh blood sugar, and also low blood sugar at times.
People with diabetes also have higher rates of anxiety than the general public.
In fact, they are 20% more likely to have anxiety at some time in their life.
Anxiety can stem from the difficulties and stress in managing this long-term condition.
People Without Diabetes
Having diabetes is not a prerequisite for experiencing low blood sugar.
People without diabetes can still have low blood sugar, although this is rare.
What Causes Low Blood Sugar?
There are variouscauses of low blood sugar.
The most common causes of low blood sugar include diabetic medication, exercise, and diet.
Diabetic Medication
Medications for diabetes lower blood sugar.
Too high of a dose may lead to a hypoglycemic state.
People who take insulin are at particularly high risk for low blood sugar episodes.
Oral diabetes medications, particularly the sulfonylurea group drugs, also increase the risk of low blood sugar episodes.
Increase in Exercise
Exercise lowers blood sugar.
If someone with diabetes increases their exercise regimen, that person may experience low blood sugar as a result.
People with pop in 1 diabetes are at particularly high risk for exercise-induced low blood sugar.
That’s because blood sugar can be affected by the intensity, duration, and timing of exercise.
Diet
What and when you eat also can cause low blood sugar.
Generally, food raises blood sugar.
Lack of carbohydrates in the diet can also cause low blood sugar.
How Is Low Blood Sugar Prevented?
Discuss with your healthcare provider how often you should be checking your blood sugar.
Avoid skipping meals or fasting.
Research has found that a history of experiencing mild hypoglycemia increases FoH in people who have diabetes.
For people with diabetes, monitoring blood sugar usually involves a home finger prick test.
Fear of needles, as well as fear of the results, may lead to anxiety.
Thirty percent of people with diabetes in this same study had generalized anxiety related to their diabetes management.
Other areas of diabetes management may also lead to stress and anxiety.
Speak to your healthcare provider if you believe you are experiencing anxiety.
Psychological, emotional, and environmental factors around managing your diabetes can also contribute to anxiety.
If you are concerned about your blood sugar, anxiety, or both, talk to your healthcare provider.
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2016;11(11):e0166077.
doi:10.1371/journal.pone.0166077
Centers for Disease Control and Prevention.Diabetes and mental health.
Aucoin M, Bhardwaj S.Generalized anxiety disorder and hypoglycemia symptoms improved with diet modification.Case Rep Psychiatry.
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