Mental health and anxiety support

[SianyBee]

Hi all, diagnosed type 3c in January and still finding it all rather overwhelming and struggling to accept that I cannot have a day off from this

I have rather good control over my sugars (Well as much as you can with no two days ever being the same) but I find I'm obsessing and worrying all the time. For example today I ate out with family for the first time. Prior to going I chose what I wanted from the menu and googled similar meals amd desserts to try to ascertain a rough carb content so I didn't have to think too hard at the table. Sadly on arrival the dessert I wanted was not available so I played bolus roulette! I did quite a good job it turns out but it all totally distracted me from enjoying the company of my family. I feel like I am never fully in the moment (something I have always excelled at before now) or able to focus.

I'm struggling to accept that every thing I do, eat, walk, exercise, drive, sleep, all involves so much mental effort so as to avoid hypos or highs. I am also worrying about going to festivals,gigs, holidays, on dates (God I'll be a wreck on my next first date!) . I had no clue just how all consuming this would be and I miss being care free and being spontaneous.

I've never suffered anxiety before but have suffered depression, which I can feel creeping back. (Even been wondering if I do ask for antidepressants again will they affect my sugars as it seems anything does, even the wind changing direction!) But I want to try and prevent entering a dark place and have been considering asking for counselling.

Can I ask for those of you who have suffered health anxiety due to diabetes what helped you the most? Did counselling help? Which kind if so? Did things get easier over time?

I feel like I'm mourning the old me. The free spirit who was rather Zen and practised meditation. She is nowhere to be seen right now

 

[Peely66]

Hi @SianyBee,

I don't know anything about Type 3c ( will look it up after posting this) but I know about health anxiety, depression and have had Type 1 for 30+ years.

I think sometimes we all find it too much but the feeling of mourning is real. It is a loss. So I would say first of all accept those feelings..the 5 stages stuff...denial, anger, bargaining, depression and acceptance.

Educating myself helped me. So going on a DAFNE course and learning how to carb count. I started with carb counting from day one as that was the accepted approach to diabetes management. It went out of fashion for a while but now with continuous glucose monitoring and bolus adjustment (DAFNE) it came back as an important tool. I'm pretty gung ho about carb counting now. It just becomes second nature when you've done it for a while.

I think joining this forum is also a positive thing and is helping me at the moment so hopefully you'll find the same.

I also suffered with pretty severe anxiety and having even more anxiety about blood sugar levels didn't help. CBT helped with a lot of that stuff.

Hope some of that helps from me anyway. I'm sure there will be lots of other responses too.

 

[Inka]

Hi @SianyBee I felt upset, angry and depressed when I was diagnosed. I found what helped me most was time. That and having a good consultant who answered my questions and listened to me.

It does get easier, I promise. What I think is that you can give up your life, focus entirely on your diabetes and have perfect control every day blah blah, or you can put the little b*&%” in its place and get on with your life by not obsessing too much. It’s all a balance - both practically and emotionally.

When I go out for meals, I tend to have some insulin up front, then top up a few times as needed. I never sit there and aim to calculate every morsel that will pass my lips. It’s not possible. The same dessert can vary hugely. Judge it by eye and by taste (ie is it extra sweet) Have some insulin, the test after an hour or so and top up if needed. Unless you have meals out all the time, treat them as special occasions and loosen your control a little. It’s worth it for the mental peace. X

 

[SianyBee]

Hi @SianyBee,

I don't know anything about Type 3c ( will look it up after posting this) but I know about health anxiety, depression and have had Type 1 for 30+ years.

I think sometimes we all find it too much but the feeling of mourning is real. It is a loss. So I would say first of all accept those feelings..the 5 stages stuff...denial, anger, bargaining, depression and acceptance.

Educating myself helped me. So going on a DAFNE course and learning how to carb count. I started with carb counting from day one as that was the accepted approach to diabetes management. It went out of fashion for a while but now with continuous glucose monitoring and bolus adjustment (DAFNE) it came back as an important tool. I'm pretty gung ho about carb counting now. It just becomes second nature when you've done it for a while.

I think joining this forum is also a positive thing and is helping me at the moment so hopefully you'll find the same.

I also suffered with pretty severe anxiety and having even more anxiety about blood sugar levels didn't help. CBT helped with a lot of that stuff.

Hope some of that helps from me anyway. I'm sure there will be lots of other responses too.

Thank you for your response. I am doing a three day course with my diabetes team soon, hoping it helps. I have tried to work out carb ratios amd all seemed well but the same meals on different days , as you prob know, get totally different results so I don't really see how it helps all that much? For example the same breakfast can see me not spike then some days shoot up to 13 and stay there for hours, or maybe a brief 11 and back down fast. I've gone hypo after meals that see me rise too. This is my biggest frustration. It isn't consistent is it? If only a simple formula worked 80% of the time I would be happy but it's all bonkers amd driving me insane.

I'm grieving for sure. I'm not myself. I think I do need some antidepressants and counselling. I think a counsellor who has experience of diabetes would be best tho but not sure they exist?

 

[SianyBee]

Hi @SianyBee I felt upset, angry and depressed when I was diagnosed. I found what helped me most was time. That and having a good consultant who answered my questions and listened to me.

It does get easier, I promise. What I think is that you can give up your life, focus entirely on your diabetes and have perfect control every day blah blah, or you can put the little b*&%” in its place and get on with your life by not obsessing too much. It’s all a balance - both practically and emotionally.

When I go out for meals, I tend to have some insulin up front, then top up a few times as needed. I never sit there and aim to calculate every morsel that will pass my lips. It’s not possible. The same dessert can vary hugely. Judge it by eye and by taste (ie is it extra sweet) Have some insulin, the test after an hour or so and top up if needed. Unless you have meals out all the time, treat them as special occasions and loosen your control a little. It’s worth it for the mental peace. X

Thank you. That is what I did today. Took my estimate. Then more with dessert then another an hour later. All was good I was at 7.7 then three hours later I've sky rocketed up to 14.4!! I took a correction amd it didn't budge so I took my pre meal bolus and left it a bit longer. I've only come down 1mmol after 40 minutes! This has never happened before. I've started to eat now and added correction factor in to try and bring it down. Fingers crossed.

I think I obsess as I get scared that these highs will lead to complications unless I take total control. I am usually at least 85% in range but it's slipped this past week to 78% and I'm battling some crazy stubborn highs

 

[Inka]

Total control isn’t possible. All we can do is our best. You spotted the high and you corrected it - you couldn’t have done more.

When I’m over around 12, I find I need slightly bigger corrections due to insulin resistance from being high. I also find that my blood sugar takes longer to start moving down. It’s very frustrating but knowing it will happen helps make sense of it.

 

[SianyBee]

Total control isn’t possible. All we can do is our best. You spotted the high and you corrected it - you couldn’t have done more.

When I’m over around 12, I find I need slightly bigger corrections due to insulin resistance from being high. I also find that my blood sugar takes longer to start moving down. It’s very frustrating but knowing it will happen helps make sense of it.

Ah thank you that makes sense as to the slower decline then maybe. I was scared to eat being so high but I've had to as so hungry. Just hope the battle comes to an end before I sleep tonight.

Bit gutted it's panned out this way for my first time eating out.

Can I ask if it's common to get these three hour spikes please? I was in range until that point then boom!! Makes it so hard to know when to bolus

 

[Inka]

When I correct a ‘normal’ high, it takes 70-120 mins to start coming down approximately, but can be approaching three hours for a high above 12.

For your spike, it depends on what you ate eg higher fat can delay a spike, and also how many carbs you had. I find more than 90g carbs very approximately in a meal can mean I go high later. I guess my body takes time to process the extra carbs.

Don’t be gutted. I’ve had a 19 eating out before! (Totally underestimated the carbs and how much I’d gobbled of some starter snacks!) It was your first time - you did well because you were thinking about what you were doing and making sensible decisions 🙂 You’ve corrected the high promptly so that’s great. If you can work out what pushed you a little high then next time you can sort it. I’d also add that sometimes just the relaxedness of the meal can push me high. That is, I’m sitting down longer and chatting, rather than getting up and moving.

We’re trying to do a very hard job - be our own pancreas. It’s not easy at all. So think about how well you’re doing and don’t dwell on the highs too much. Everyone will get highs. My consultant says as long as they’re corrected that’s ok.

 

[trophywench]

It usually happens when the first thing or things we eat, contain more fat than usual - so a prawn cocktail is beautifully low carb but high fat since mayo etc has a goodly amount of olive oil in it for it's first ingredient. (Google the words 'Pizza Effect' to find out more - the cheese slows the 'bread' base down considerably - I spike approx 5hrs later with an actual pizza) Much the same can apply to chips!

 

[SianyBee]

It usually happens when the first thing or things we eat, contain more fat than usual - so a prawn cocktail is beautifully low carb but high fat since mayo etc has a goodly amount of olive oil in it for it's first ingredient. (Google the words 'Pizza Effect' to find out more - the cheese slows the 'bread' base down considerably - I spike approx 5hrs later with an actual pizza) Much the same can apply to chips!

I am vegan so had a Bali bowl, which was sticky tempeh, spiced greens, sweet potato, coconut rice and a drizzle of satay dressing. I think I worked out the carbs content well for it. Then after I had a raw sugar free millionaires slice, with dates, almond flour, nut butter etc.

I've found I am fine with chips and have them quite often, same with potatoes.. they don't affect me nor does rice. But if my meal is on the large side then I do find the spike is later, I tried a split bolus (1 hour apart) with a curry last week amd it worked a treat . Maybe today's meal needed a similar approach?

I haven't dared to try pizza yet but do want to!

 

[SianyBee]

When I correct a ‘normal’ high, it takes 70-120 mins to start coming down approximately, but can be approaching three hours for a high above 12.

For your spike, it depends on what you ate eg higher fat can delay a spike, and also how many carbs you had. I find more than 90g carbs very approximately in a meal can mean I go high later. I guess my body takes time to process the extra carbs.

Don’t be gutted. I’ve had a 19 eating out before! (Totally underestimated the carbs and how much I’d gobbled of some starter snacks!) It was your first time - you did well because you were thinking about what you were doing and making sensible decisions 🙂 You’ve corrected the high promptly so that’s great. If you can work out what pushed you a little high then next time you can sort it. I’d also add that sometimes just the relaxedness of the meal can push me high. That is, I’m sitting down longer and chatting, rather than getting up and moving.

We’re trying to do a very hard job - be our own pancreas. It’s not easy at all. So think about how well you’re doing and don’t dwell on the highs too much. Everyone will get highs. My consultant says as long as they’re corrected that’s ok.

Thank you 🙂 I hope I feel more relaxed over time. I'm a bit of a perfectionist and also love patterns and logic but there doesn't seem to be much of either with diabetes! This is the most frustrating thing for me, the inconsistency. I want to control it well but the unpredictable nature makes it impossible a lot of the time.

With regards to corrections I know when I take my morning pre bolus I can drop a good few mmol in just that 20 minutes time frame. So I was expecting the same tonight but no budge. But maybe the dessert was still being absorbed hence preventing it.

Do you split bolus for larger meals please? I'm wondering if that approach would work better with certain meals with higher protein or fats? So much trial and error isn't there.

 

[trophywench]

I have no experience whatever of adjusting insulin with a vegan diet so am clueless. In the absence of carbs you need insulin to convert both protein and fat to glucose and all I can tell you is that with an omnivorous diet you'd try 40% of your I:Carb ratio and for fat, 10%. However when not mega low carb people generally find their body does not need to convert either protein or fat to glucose, since the carb produces enough glucose. Mine never has because I always try to eat a balanced diet.

 

[SB2015]

Welcome to the forum @SianyBee

Sorry to hear how frustrating things are for you at present. It is hard work, and perfection is definitely impossible. We can only do our best, and you are doing brilliantly if you have TIR over 70%. So the strategies you are using are working well, but they never work 100% of the time. I can relate to your frustrations as it took me a long time to accept the impossibility of perfection. I found I got better and better at keeping levels in range and then it just didn’t improve. I did hit a wall and eventually asked for help, so don’t be afraid to tell your team how you are feeling. Be honest. This won’t be the first time they have come across it.

I find that whenever I have a bigger meal I have to increase my Bolus doses. I worked at a rule of thumb that worked (most of the time) for me. That could be worth discussing with your team. As @Inka has said this can also apply to correction doses.

With fatty meals I found that I needed to spread the delivery of my insulin. This became easier once I was on a pump, but with injections I was splitting my dose. So for a meal out, I would put in an estimated amount at the start (restaurants often have carb info on their website) then I would add a bit more if I fancied a pud or thought I had had more. The most important thing is to enjoy the meal out. It is not something you are going to do every day, it is unlikely to be a repeated menu, so no point in being too precise.just do the best you can, accept that it might be a bit of a yo-yo overnight, with maybe an extra check. In the long term it is not going to cause a big issue. It is just a blip.

With regard to the anomalies of levels simply not behaving the same all the time, you are right they don’t. I used to think that my ratios were fixed, but when I joined this forum I realised that people were changing the ratios loads. I now find I need to do this with changes in the weather. I have a seasonal wardrobe, and seasonal ratio changes.

Keep in touch on here as well as working with your team. Ask any questions that you have. There is plenty of support on here from people that ‘get it’.

 

[Inka]

Hi @SianyBee I have a pump so I have an option of different boluses eg extended, but on injections I did split boluses sometimes, yes. This was for things like pasta and also for eating out. Sadly there’s no special rule for this - it’s just experience. You’ll gradually become aware of the best way to deal with various meals and situations. With lots of meals out or special occasions, I also tend to correct/add insulin when needed. Please don’t think I sit there doing special calculations and have perfect blood sugar - I don’t even after almost three decades of the silly diabetes. There are always curve balls.

So you could experiment with a similar meal again and see what works bolus-wise. The meal sounds delicious, by the way, and I hope you enjoyed it.

Sometimes you just have to manage your blood sugar over the hours rather than enact some foolproof plan because so many things can change. Although we’re carefully thinking about our insulin, we’re dealing with a biological system not a machine, so there’s always an element of estimation even on normal days.

 

[helli]

Welcome @SianyBee diabetes is a pest, isn't it?
Things do get easier over time but it is especially a challenge if you are a perfectionist.
I try not to think of controlling diabetes but managing it. I compare it to a manager in an office. They don't control their employees. If one of their employees decided to steal paperclips, it's not the manager's fault but they can do something about it when they notice the paperclip supplies going down too quickly.
With diabetes, we are the managers. When our blood sugars start falling (or rising) quickly, it is not our fault but once we detect it, we can do something about it.
The paperclip thief does not behave the same all the time - sometimes they don't take any and other times, sometimes they take a few and sometimes they clear the cupboard. The way the manager will behave when they clear the cupboard will be different to what the manager will do if they take half a dozen.
Diabetes is the same - sometimes it behaves, sometimes it causes blood sugars to go a couple of mmol/l higher than we'd like and sometimes it rockets into the teens (or higher). When our blood sugars go high, we can experience insulin resistance so we may need more insulin to bring it back down.

I hope my analogy makes sense ... although who uses paperclips any more?

 

[SianyBee]

Welcome to the forum @SianyBee

Sorry to hear how frustrating things are for you at present. It is hard work, and perfection is definitely impossible. We can only do our best, and you are doing brilliantly if you have TIR over 70%. So the strategies you are using are working well, but they never work 100% of the time. I can relate to your frustrations as it took me a long time to accept the impossibility of perfection. I found I got better and better at keeping levels in range and then it just didn’t improve. I did hit a wall and eventually asked for help, so don’t be afraid to tell your team how you are feeling. Be honest. This won’t be the first time they have come across it.

I find that whenever I have a bigger meal I have to increase my Bolus doses. I worked at a rule of thumb that worked (most of the time) for me. That could be worth discussing with your team. As @Inka has said this can also apply to correction doses.

With fatty meals I found that I needed to spread the delivery of my insulin. This became easier once I was on a pump, but with injections I was splitting my dose. So for a meal out, I would put in an estimated amount at the start (restaurants often have carb info on their website) then I would add a bit more if I fancied a pud or thought I had had more. The most important thing is to enjoy the meal out. It is not something you are going to do every day, it is unlikely to be a repeated menu, so no point in being too precise.just do the best you can, accept that it might be a bit of a yo-yo overnight, with maybe an extra check. In the long term it is not going to cause a big issue. It is just a blip.

With regard to the anomalies of levels simply not behaving the same all the time, you are right they don’t. I used to think that my ratios were fixed, but when I joined this forum I realised that people were changing the ratios loads. I now find I need to do this with changes in the weather. I have a seasonal wardrobe, and seasonal ratio changes.

Keep in touch on here as well as working with your team. Ask any questions that you have. There is plenty of support on here from people that ‘get it’.

Thankyou so much for this. It means a lot and is very helpful. I am usually about 85% plus in range but the past few days only 65% due to the bizarre stubborn highs happening at about three hours post meal. I would love to be able to prevent those rather than correct really as I am quite anxious to bolus before bedtime due to night time hypo anxiety (Even tho that's only happened once! But living alone I worry about it) .

So is 70% in range classed as good control please? And when you say in range do you refer to the whole time period or just the pre meal levels falling in range 70% of the time? I guess I worry about what is considered good and will avoid long term complications.

I actually read your thread last night from a few years ago about techniques that helped you amd it was extremely interesting and helpful to me. I hope I can develop some similar techniques and relax over time.

 

[SianyBee]

Welcome @SianyBee diabetes is a pest, isn't it?
Things do get easier over time but it is especially a challenge if you are a perfectionist.
I try not to think of controlling diabetes but managing it. I compare it to a manager in an office. They don't control their employees. If one of their employees decided to steal paperclips, it's not the manager's fault but they can do something about it when they notice the paperclip supplies going down too quickly.
With diabetes, we are the managers. When our blood sugars start falling (or rising) quickly, it is not our fault but once we detect it, we can do something about it.
The paperclip thief does not behave the same all the time - sometimes they don't take any and other times, sometimes they take a few and sometimes they clear the cupboard. The way the manager will behave when they clear the cupboard will be different to what the manager will do if they take half a dozen.
Diabetes is the same - sometimes it behaves, sometimes it causes blood sugars to go a couple of mmol/l higher than we'd like and sometimes it rockets into the teens (or higher). When our blood sugars go high, we can experience insulin resistance so we may need more insulin to bring it back down.

I hope my analogy makes sense ... although who uses paperclips any more?

Welcome @SianyBee diabetes is a pest, isn't it?
Things do get easier over time but it is especially a challenge if you are a perfectionist.
I try not to think of controlling diabetes but managing it. I compare it to a manager in an office. They don't control their employees. If one of their employees decided to steal paperclips, it's not the manager's fault but they can do something about it when they notice the paperclip supplies going down too quickly.
With diabetes, we are the managers. When our blood sugars start falling (or rising) quickly, it is not our fault but once we detect it, we can do something about it.
The paperclip thief does not behave the same all the time - sometimes they don't take any and other times, sometimes they take a few and sometimes they clear the cupboard. The way the manager will behave when they clear the cupboard will be different to what the manager will do if they take half a dozen.
Diabetes is the same - sometimes it behaves, sometimes it causes blood sugars to go a couple of mmol/l higher than we'd like and sometimes it rockets into the teens (or higher). When our blood sugars go high, we can experience insulin resistance so we may need more insulin to bring it back down.

I hope my analogy makes sense ... although who uses paperclips any more?

I love this analogy 🙂 blasted paperclips hey! Haha. I do try to control it yes, but managing it (a more reactive in some ways) approach does seem a better way to look at it for sure.

I get frustrated at how one day my breakfast stays in range then the next it shoots outta the stratosphere. Yesterday it did this so I took a correction pre two hours, naughty I know, and I went hypo at the start of the meal. My sensor didn't detect it, only the second time this has happened, it said 5.6 but I was 3.6! So it didn't set off the meal great from the start really amd shook me up a bit.

 

[Anxious 63]

Hi there i have type 2 diabetes but also suffer from anxiety and depression , regarding the diabetes i think like any illness if you are stressed it makes everything worse , try to eat the right things , exercise when you can and get your rest and sleep, i think some medical professionals forget that everybody is different and they seem to think we are all wired the same way this is simply not true , i have found there is some really good advice on this forum

 

[SianyBee]

Hi there i have type 2 diabetes but also suffer from anxiety and depression , regarding the diabetes i think like any illness if you are stressed it makes everything worse , try to eat the right things , exercise when you can and get your rest and sleep, i think some medical professionals forget that everybody is different and they seem to think we are all wired the same way this is simply not true , i have found there is some really good advice on this forum

Thank you. Could I ask if you have ever taken antidepressants please? Did these have any effect on your sugar levels? I think I will be speaking to my doctor this week about starting back on them. I came off my last lot about two years ago and have been doing really great until my diagnosis in January. I was actually feeling mentally and physically better than ever since the lockdown started hence it has all come as a huge shock

 

[Anxious 63]

Yeah been on lots of different meds , some of them can increase your sugar levels , cymbalta is supposedly for good nerve pain due to Diabetes , i am afraid all they will say is all meds have side effects its hit and miss with a lot of meds