Many people with diabetes worry about having low blood sugar (hypoglycaemia, or ‘hypo’s’).
To a certain extent, worrying about low blood sugar is a normal and healthy phenomenon in all diabetes patients on insulin (or other blood glucose lowering medication). However, in some people normal and healthy worries develop into hindering anxieties, that influence their blood sugars and quality of life. Often, these anxieties develop after having experienced a serious hypo, needing help from others, and/or being unconscious. But in some people these hindering anxieties might also develop without having experienced a serious hypo.

Many people with fear of hypoglycaemia worry about:

-having a hypo while asleep (or even dying from a hypo in their sleep)
-losing consciousness in public, while driving or being alone at home
-needing help from others, attracting unwanted attention

In some people these anxieties are so intense that they will make sure their blood sugar never drop below a certain level. They might eat some extra carbs before going to bed, before/while driving, or before going out, even when their blood sugar don’t really ‘need’ an extra snack. Or otherwise, people might use less insulin than they should, just to make sure that their blood sugar won’t drop. Some might check their blood sugars excessively, to monitor potential blood sugar drops.
These are all common behavioural reactions to anxiety, and are called ‘’safety behaviours’’. In the short term, these safety behaviours help to prevent/decrease anxiety. However, in the long term, these behaviours make people more insecure about low blood sugar, and help to develop even more anxiety.
That is why it is so important to limit the ‘’safety behaviours’’ to a healthy and rational amount.

If you recognize these anxieties and safety behaviours, there are a few steps to take:

• it is good to let others know about it. Best would be to inform your partner/significant other, as well as your diabetes health care professional (s).
• make a list of the questions/worries you have about hypo’s. Explain what your fears are about
• make a list of the specific safety behaviours that you perform to reduce your anxiety
• let a diabetes health care professional educate you about hypoglycaemia
• let a diabetes health care professional help you in making a stepwise plan on how to limit these safety behaviours