Mood swings and diabetes

Does Diabetes Cause Mood Swings?

Diabetes and mood swings go hand-in-hand. Mood swings are so much a part of diabetes that when doctors are asked if diabetes causes mood swings, they don’t hesitate to answer with a solid and simple, “yes.” The more you understand about the connection between diabetes and mood swings, the better equipped you’ll be to recognize them and take action to manage both mood swings and diabetes.

Mood swings can occur throughout the day, and mood can even fluctuate from one minute to the next (“Diabetes and Irrational Behavior, Mental Confusion”). If you or someone you know has ever felt neutral or happy and then suddenly, without warning, become crabby and angry or sad and upset, know that these feelings aren’t overreactions and they most certainly aren’t character flaws. They are mood swings that come with diabetes.

With diabetes, mood swings can be your friend. They’re often the first sign that blood sugar levels are out of control. That said, mood swings aren’t at all friendly, and they can take a toll on your mental health. Knowing the reasons for them can help you take measures to attend to your diabetes and mood swings.

Diabetes and Mood Swings: Why Diabetes Causes Mood Swings

Changes in mood are part of diabetes, no matter the type. Type 1 and type 2 diabetes and mood swings have the same underlying causes. The climbing and crashing of moods aren’t arbitrary. They’re part of diabetes and have multiple causes:

  • Blood glucose (sugar) fluctuations
  • Diabetes distress
  • Uncontrolled diabetes
  • Depression

Blood sugar fluctuations, also known as glycemic variability, can directly cause mood swings. Mood swings that happen because of blood sugar spikes and dips are physiological in nature rather than emotion-based. Blood glucose can fluctuate whether diabetes is uncontrolled or well-managed.

In addition to physiological components, mood swings in diabetes have psychological causes. Depression and diabetes frequently co-occur. Further, the stressful nature of the disease contributes to variations in mood. Let’s take a closer look at the physiological and psychological reasons for the link between diabetes and mood swings.

Blood Sugar Levels and Mood Swings

Diabetes is a disease in which the body can’t regulate its source of energy, which is glucose. Glucose is created during the digestion process. It enters the bloodstream and travels throughout the body to enter the cells and provide energy. Glucose, though, can’t get into the cells on its own. It’s as if it doesn’t have a key. Insulin, a hormone made in the pancreas, is that key. Normally, insulin is made and released, and it escorts glucose into the cells. In diabetes, though, either the body doesn’t produce enough insulin (or even any at all), or the body doesn’t use the insulin efficiently.

A healthy blood sugar level falls between 70 and 140 mg/dL. Dropping below 70 mg/dL or spiking above 140 can cause mood swings. Something quite frustrating to those living with diabetes is that even blood sugar fluctuations within the healthy range can cause mood swings.

Low blood sugar (hypoglycemia) happens if someone doesn’t take enough insulin or doesn’t eat enough food to supply glucose. Alcohol consumption plays a role in hypoglycemia, too. Hypoglycemia causes mood swings because glucose is what the brain needs to function. Without enough of it, it suffers. Mood swings are a result. High blood sugar affects the brain, too; the excess sugar leaves it wired, irritable, and unable to concentrate.

Emotional fluctuations, even anger caused by diabetes and mood swings, aren’t necessarily part of a mood disorder. Instead, they’re a biological component of a serious disease. This doesn’t mean, however, that mood swings in diabetes are only biological. There is a strong psychological component to them as well (“What are the Effects of Diabetes on Mood Disorders?”).

Psychological Cause of Diabetes and Mood Swings

When someone has diabetes, he or she must manually run the insulin-glucose process by continually monitoring blood sugar levels and taking the necessary steps to keep them within a healthy range. It doesn’t end. Self-managing diabetes is challenging and can cause diabetes distress, a state of mind arising from the worry, stress, and rigors of managing blood sugar.

Understandably, diabetes distress causes mood swings. The negative moods that are part of the swings can happen without warning. Common, and very normal, feelings can involve

  • Anger
  • Resentment
  • Guilt
  • Self-blame
  • Excessive stress
  • Irritability
  • Sadness

Diabetes and mood swings can reduce the quality of life and lead to more negative moods. It’s not uncommon for someone to develop major depression when living with diabetes.

Mood swings are a part of diabetes. If they are interfering in your life, see your doctor, a diabetes educator, or a therapist specializing in diabetes. Yes, diabetes causes mood swings; however, diabetes and mood swings don’t have to ruin your life.

article references

Mood changes can be a common experience in people with diabetes, both type 1 and type 2. Medtronic Diabetes Clinical Manager Gina, who has lived with type 1 diabetes for more than 39 years, addresses the affect blood sugar levels can have on your everyday emotions.

The other day, I was driving and was suddenly overcome by a feeling of intense sadness; I started to cry. At the time, I thought I was reacting emotionally to a stressful week; I had been looking for a home to purchase, and my offer on a townhome I really liked had been rejected. Then, my Low Predictive alert sounded on my pump, and I realized the reason for the sudden change in my emotions was because my blood glucose (BG) had been dropping and was approaching a low level. Once my BG stabilized, I was fine. The sadness went away as quickly as it had come. Has this ever happened to you?

There is a Reason: Your Brain!

Well, there is an explanation! Your brain, the center of your thoughts and emotions, needs glucose to do its job. If you don’t have enough glucose to “feed your brain,” your brain can go “haywire”. Even though it seems like you are overly emotional, this is really a physical response to low BG (hypoglycemia). You don’t have to be below a certain number, like 70 mg/dL, to experience this. Your BG may be in the 80-130 md/dL range, or possibly higher, when the reaction occurs. It can be due to a rapid drop in your BG level instead of the actual level (1).

Can high BG’s (hyperglycemia) affect your immediate emotions? It probably will not surprise you the answer is “yes.” High BG’s can make it difficult to think and concentrate. I know some people with diabetes tend to get grouchy and irritable when our sugar is high because any blood sugar outside of our desired range can make us feel weird, uncomfortable, and emotionally off-balance (2). This can all vary greatly from person to person, but it’s an interesting symptom to be aware of.

Our Friends and Family

Those who know me well know that if I say I am feeling “wonky” or “out of sorts,” or if I am acting out of character, it could be a BG issue. I have to admit when these same people, people I care for deeply, suggest I check my BG, I have been known to react in a less than positive way that requires an apology later. Thankfully, these same friends and family members know the rudeness is not “me,” but my brain’s reaction to lack of sugar/energy.

Sense of Humor: Critical when Living with Diabetes!

Remember that Snickers® campaign ad from a couple of years ago that showed someone having less than desirable behavior? A friend would tell the person to eat a Snickers candy bar, and suddenly the behavior was gone and the true person reappeared. The negative change in personality was due to lack of brain fuel. They needed sugar! This may be a good way to explain it to your friends and family (when your BG is normal) so they have something other than your behavior to base their responses on. That way, they are less likely to be offended if you lash out at them. It may actually add some humor to an often difficult situation.

You may tell your friends and family, “If I start acting like Oscar the Grouch (insert your choice of character) for no reason, it might be because my BG level is dropping, or because my sugar is too high. Try not to take it personally and just guide me through the process of testing my BG and treating the low/high as indicated. I apologize in advance if I act mean and nasty, and I truly appreciate your love and support.”

By the way, I am not suggesting you use a candy bar to treat a low BG, as it may have too much fat to treat a low; always follow the advice of your healthcare team (not a TV commercial) when treating low BG’s!

Online References:

Guest Blogger – Gina Addy McKelvey, FNP, CDE

Gina Addy McKelvey is a Family Nurse Practitioner, Certified Diabetes Educator, and Medtronic Diabetes Clinical Manager in Charleston, South Carolina. She has been living with type 1 diabetes for 39 years, and believes those living with diabetes can live long, healthy, productive, happy lives. She’s thrilled about the advances in diabetes management she’s witnessed over 39 years, and believes the best is yet to come. Gina has used insulin pump therapy for over 25 years, and continuous glucose monitoring (CGM) for about 6 years.

You may remember Gina from Battling The Blues With Exercise.

Tags: blood glucose, mental health

Mental Health

Beware of denial

As with pretty much every emotion you feel when you’re diagnosed with diabetes, denial is natural. Everyone feels that sense of, “not me,” or “I don’t believe it,” or “there must be some mistake.” But at some point, you have to accept your diagnosis and take action. By continuing to deny it, you run the risk of not taking action to fight the disease and keep yourself healthy.

An important part of steering out of denial is recognizing how it sounds in your head—and how it makes you avoid critical care. If you catch yourself saying or thinking any of the following phrases, you may be in denial:

  • “One bite won’t hurt.”
  • “This sore will heal itself.”
  • “I’ll go to the doctor later.”
  • “I don’t have time to do it.”
  • “My diabetes isn’t serious.”

Everyone goes into denial from time to time—but there are things you can do to make sure you don’t stay there. Work with your diabetes care team to make a plan and set your goals. Ask your diabetes educator for help and be accountable to them. And tell your family and friends how they can help you stick to your treatment plan.

Depression can sneak up on anybody

Sometimes, there’s a sadness or an emotional flatness that just won’t go away. Sometimes, you just feel hopeless—and have no idea what comes next. However it shows up, depression can be hard to detect and can wreak havoc with your self care. Spotting depression is important—and it’s important to check for these symptoms:

  • Loss of interest or pleasure
  • Change in sleep patterns
  • Waking up earlier than normal
  • Change in appetite
  • Trouble concentrating
  • Loss of energy
  • Nervousness
  • Guilt
  • Morning sadness
  • Suicidal thought
  • Withdrawal from friends and activities
  • Declining school and work performance

Anger can be extremely destructive emotion with a detrimental impact on our physiology as well as our mental and emotional well being.

What is anger?

Anger is a strong feeling of displeasure, resentment and hostility that often arises in response to a perceived wrong doing.

Anger initiates the stress response within the body causing blood sugar levels to rise, heart rate and blood pressure to increase.

It is normal for people with diabetes to experience anger, often questioning why it is them with diabetes whilst other people are healthy.

Why should I be mindful of anger?

Anger frequently contributes to diabetes burnout, a person’s anger may encourage them to seek ‘freedom’ from the condition and neglect their self-management.

It must be noted that anger is a natural emotion that has its uses in human existence, yet if not controlled, can lead to negative effects on health and social relationships.

How can I manage anger?

Mindfulness based approaches are recognised as an effective and lasting means of aiding the management of anger.

Research has shown that by becoming aware of the triggers as well as the emotional, mental and physical impact of anger, an individual is able to recognise and respond rather than react to triggers which may have initiated an automatic reaction.

Why does anger need controlling?

Anger if left un-addressed has the power to become hugely destructive, having a negative impact on mental and physical health including reduced glycaemia control.

Patterns of anger expression have been associated with maladaptive alterations in cortisol secretion (sometimes referred to as the stress hormone), immune functioning, and surgical recovery.

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Type 1 diabetes (T1D) may be a physiological condition, but it comes with an emotional impact that should never be underestimated. Daily regimens, lifestyle changes, worries about complications, and other significant anxieties can cause emotional stress — also known as diabetes distress. Diabetes distress can reveal itself in feelings of anger, resentment, guilt and irritability.

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It is easy to see how these psychological aspects of managing T1D can affect you emotionally, but there is more to bad moods than psychological stress; in T1D, these moods also have a physiological basis.

Blood glucose fluctuations

When not effectively regulated, fluctuations in blood glucose levels can have a significant effect on emotions. You may already be aware of feeling tense and angry when your blood sugar is high and nervous and tearful when your sugars are low. These emotions tend to resolve when you manage to stabilize your glucose levels. Sometimes, it’s not even the blood glucose levels, but rather the rapidness of fluctuations that may cause a sudden rise in certain emotions.

Although studies have confirmed that fluctuations in blood sugar usually have an impact on moods, the specific emotions evoked by either hyperglycemia or hypoglycemia have been found to be rather idiosyncratic. This means that even within the same person, low or high blood sugar may cause different mood changes at different times. However, the most common emotions associated with high blood sugar are anger and sadness, while with low blood sugar, nervousness and irritability are more common.

So, what exactly is happening in the body to cause these mood changes?

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Type 1 diabetes and mood: the highs and lows

The human brain requires glucose to function, and when the glucose in your blood is insufficient, your brain tends to become “weak.” The resulting mood changes are due to the lethargy that comes from your brain not getting the energy it needs; you simply lack the brain power to manage your moods. Furthermore, hypoglycemia can affect levels of acetylcholine, a neurotransmitter responsible for transmitting signals between brain cells, specifically signals that control psychological and physical functions like breathing, heart rate and muscles. This may explain why some people report experiencing a slightly euphoric feeling, similar to being mildly drunk, when their blood sugar drops.

Conversely, too much sugar in the blood has the adverse effect of putting your brain on very high alert. In people with T1D, a rise in sugar levels also increases the chemical glutamate in the region of the brain that controls emotions. Glutamate has been linked to depression, and this response to increased sugar levels only occurs in people with T1D. This explains why many people report being in a very low mood akin to depression when their blood sugar rises. If it persists over a long period of time or happens frequently, high blood sugar can lead to depression.

Managing your moods

The emotional impact of T1D can significantly affect your quality of life and even your physical safety in certain situations. Managing your emotional health is therefore as important as managing your diabetes. Considering that your mood can be influenced by both the psychological or physiological effects of T1D, or sometimes by both, it is necessary to guard against both.

The mood management strategies that will work for you may change as rapidly as your emotions, so have several options at hand. Some examples include:

• Develop an extended support system. This could include diabetes support groups, family members, friends, your doctor or a diabetes coach.

• Journal or blog about your daily struggles as an outlet for negative moods.

• Meditate and find time to relax.

• Infuse an abundance of humor into your life.

• Volunteer at your favorite charity.

• Follow your diabetes management plan carefully and avoid sudden spikes or dips in blood sugar.

• Keep a mood diary to record when you have mood swings to determine what your key triggers are.

• Use the kind of continuous glucose monitoring (CGM) system that shows how fast your blood sugar is rising or falling, such as the Dexcom G6 CGM.

• Educate the people around you about your potential for mood swings due to fluctuating blood glucose levels.

• Be armed with a generous dose of self-forgiveness.

T1D and moods are interwoven in many ways, but that doesn’t mean you are completely out of control of your emotions. Know how your glucose highs and lows impact you and prepare in advance for dealing with these fluctuations. In other words, put yourself in the driver’s seat!

Want to learn more about diabetes and mood? Read “Beating the Winter Blues,” “Snap Out of It: Using Food to Boost Your Mood” part 1 and part 2 and “Reducing Diabetes Stress.”

Can Diabetes Affect Your Mood?

Q1. My husband has type 2 diabetes, which is now being controlled by medicine. I find that he is sometimes particularly irritable or even mean, which is very out of character for him. Is this common with type 2 diabetes, or with high or low readings?

— Sally, Florida

It is great that you are seeking a better understanding of your husband’s illness. Diabetes is a disease that not only affects individuals but also those close to them. As a result, those who have good family support in the care of their diabetes do much better in managing their illness.

There are a few reasons for behavioral changes like those you see in your husband among people with diabetes. One is the effect of abnormally low glucose levels in the bloodstream. The other reason is depression, which can be triggered by the diagnosis of diabetes, the burden of daily management, and fear of complications.

Low glucose levels can cause symptoms including impaired judgment, anxiety, moodiness, belligerence, fatigue, apathy, confusion, dizziness, blurred vision, and a lack of coordination. I would advise your husband to check his sugar levels at the times when he is irritable. If his mood is indeed due to low glucose levels, the symptoms will improve if he raises his blood sugar, for example, by drinking orange juice or taking glucose tablets. It is also important to consult with his doctor to adjust his medicines or dietary intake.

On the other hand, your husband’s irritability can be a manifestation of depression. Many people with depression are undiagnosed and thus do not receive the necessary counseling and treatment. Also, depression symptoms vary from person to person, which can make it difficult to diagnose. Signs such as lack of sleep, overeating or lack of appetite, poor concentration, and other symptoms help in the diagnosis of depression.

In any case, depressed individuals have difficulty with the demands of daily diabetes care. This turns into a cycle of poor glucose control leading to depression, and depression causing further glucose abnormality.

There are other reasons that can cause behavioral changes like those you describe. Your husband’s doctor might shed better light on these possibilities.

Q2. My husband has type 2 diabetes and is having problems urinating. His prostate is not enlarged, but his kidneys are getting bad. When he does go to the bathroom, hardly anything comes out, and he has to go about 30 times a day and night. Is there anything he can take or do that can help?

— Linda, Nevada

The first step in managing your husband’s urinary difficulty would be to consult his doctor to determine the reason for his symptoms. It seems that his kidneys are failing as a result of his diabetes (diabetic nephropathy). This can eventually limit the amount of urine he is able to produce. However, other reasons for his current symptoms should be investigated. As part of the examination, his doctor will consider conditions like urinary tract infection, which can cause similar symptoms; dehydration, which might limit his urine output; and other conditions that affect kidney function.

The treatment of diabetic nephropathy focuses on preventing further decline in kidney function. This can be achieved by controlling glucose levels and blood pressure and limiting protein intake to about 0.8 mg/kg/day. Your husband’s doctor will also determine whether he is a candidate for a class of medicines that will slow the progression of diabetic kidney disease.

Q3. I was diagnosed with diabetes in 1993. In the last three years, I’ve let my diabetes go uncontrolled because of depression. I don’t even bother checking my glucose anymore. I’m a need-to-see-it-to-believe-it type of person, and because I have never experienced severe complications, I don’t believe they’ll affect me. What signs do you look for when you’re dying because of complications from diabetes? I think I will need to be really scared to commit to my own care, but I don’t want to pass the point of no return. This is the first time I have ever opened up about this.

— Diana, Colorado

First of all, I want to congratulate you for sharing your feelings and thoughts about your diabetes. You are not alone. Depression and diabetes go hand in hand, and more often than one might think. The combination of diabetes and depression makes controlling sugar levels much more difficult. However, you are in a better position than those whose depression remains undiagnosed and who suffer silently.

Untreated depression, as your experience demonstrates, takes away the desire to adhere to treatment regimens and follow-up care and makes it very difficult to engage in physical activity. Many people with untreated depression also lack the energy to consider a healthy diet, carbohydrate counting, and other kinds of general self-care.

Unfortunately, diabetes does not cause bothersome symptoms for many years, even as it wreaks havoc in the body. You won’t have any clues that indicate organ injury or other serious problems. This complete lack of symptoms can remove the sense of urgency to care for diabetes. In your case, it sounds as though you doubt you even have the disease.

Often the only signs that indicate the severity of diabetes are high glucose levels and the proportion of hemoglobin A1C in the blood. If your glucose levels are consistently above 120 mg/dl and your doctor tells you that your hemoglobin A1C is above 7 percent, you are at risk for kidney, nerve, artery, and retinal damage, and you’re at a much higher risk for heart attack and stroke. In fact, 75 percent of people who have diabetes die of heart disease.

Even when you show no symptoms, it is important to make sure that your sugar levels remain within the normal range. By doing so, you stave off irreversible complications that can be devastating later on. Most important, make sure your depression is treated so that you have the energy and the desire to care for your diabetes. I urge you to see your physician to talk about how to treat your depression. Once you start to feel better, you can direct your energy toward getting your blood sugar under control. Best wishes in managing both your diabetes and your depression!

Learn more in the Everyday Health Type 2 Diabetes Center.

Is Your Mood Disorder a Symptom of Unstable Blood Sugar?

Isa Kay, MPH ’18

October 21, 2019, Alumni, Nutritional Sciences, Mental Health, Nutrition

Many people may be suffering from symptoms of common mood disorders, such as depression and anxiety, without realizing that variable blood sugar could be the culprit.

A growing body of evidence suggests a relationship between mood and blood-sugar, or glycemic, highs and lows. Symptoms of poor glycemic regulation have been shown to closely mirror mental health symptoms, such as irritability, anxiety, and worry. This should come as no surprise, as the brain runs primarily on glucose.

Depression currently affects about 25% of individuals with diabetes, a population more susceptible to pronounced blood sugar highs and lows.1 The diabetic population provides valuable insight on the effects of blood sugar variability on both ends of the spectrum.

Although more studies are warranted to solidify the relationship between mood and blood sugar, considering dietary and lifestyle implications on common mood disorders can rule out lesser known causes.

One study found that inconsistent blood sugar levels among women with diabetes were associated with lower quality of life and negative moods.2 Among diabetic, higher blood glucose, or hyperglycemia, has historically been associated with anger or sadness, while blood sugar dips, or hypoglycemia, has been associated with nervousness.3

Persons with diabetes are not the only ones vulnerable to mood disturbances as a result of blood sugar fluctuations. Otherwise healthy individuals consuming a diet high in refined carbohydrates and added sugars may experience a sudden surge in their blood sugar, followed by an exaggerated insulin response, leading to acute hypoglycemia.4

A 2017 prospective study found positive associations between high sugar consumption and common mental disorders, concluding that sugar intake from sweet foods and beverages has an adverse effect on long-term psychological health.5

Individuals with recurrent mental health symptoms may choose to rule out alternative causes before jumping into mental health treatment or interventions. Several lifestyle principles can help stabilize blood sugar:

  • Reduce and manage stress. Stress has been shown to negatively affect the regulation of blood glucose. Specifically, hormonal changes during acute and chronic stress can affect glucose balance.6
  • Increase intake of protein and fiber. Protein has a low glycemic index (GI), which means they have a low impact on blood sugar levels. Fibrous foods are also shown to have a lower GI value when compared to their refined counterparts.7
  • Reduce intake of sweet beverages and refined carbohydrates. A diet high in refined carbohydrates, including sweet beverages, has a high GI value and is associated with unstable blood sugar regulation.4,7

Although more studies are warranted to solidify the relationship between mood and blood sugar, considering dietary and lifestyle implications on common mood disorders can rule out lesser known causes.

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About the Author

Isa Kay, MPH, RDN is a Registered Dietitian Nutritionist and completed her Master’s of Public Health in Nutritional Sciences from the University of Michigan School of Public Health. She is also a Navy veteran, yogi, and integrative health coach. Treating the body as an interconnected whole, Isa links nutrition with brain health, mood, and mental wellbeing. Her continued interests include the emerging field of nutritional psychiatry, functional medicine, and the gut-brain axis. You can follow Isa on social media at @meanutrition.

How Diabetes Causes Mood Swings (and What to Do About It)

Diabetes Mood Swings: The Roller Coaster You Don’t Want to Ride

All of a sudden you feel it: your teeth are clenched, your blood is boiling and you wonder if people can see the smoke coming out your ears. Is it possible that type 2 diabetes caused this sudden mood change?

Yes. Not only can diabetes be responsible for mood changes, but it can take a toll on your emotions in general.

From anger to depression to anxiety, diabetes can take you across a spectrum of feelings. This roller coaster can leave you just plain exhausted. Let’s take a look first at the feelings and possible causes and then in some ways to cope with diabetes mood swings.

Anger

A common feeling, whether you’ve just been diagnosed or had diabetes for years, is anger. Not only are many diabetics angry at being diagnosed with the disease and ask “Why me?” but they are also made to feel guilty that their own lifestyle choices have led them to this diagnosis.

This can build up and start to cause resentment problems in the relationships with those that may not be as supportive as they could be.

Depression

There are many reasons those of us with diabetes can feel depressed. With a diabetes diagnosis comes the need for many lifestyle changes — and that is not an easy task.

If you are someone who never really paid attention to what you ate and didn’t have a set exercise routine, you will find the new requirements of counting carbs and getting some exercise in to be a bit daunting at first.

Many people will also be unhappy with having to take medicines and the fact that these medicines may have unwanted side effects such as sexual dysfunction and digestion issues. The burden alone of the daily management of diabetes can be a cause of depression.

Anxiety

Anxiety is also common among people with a chronic illness such as diabetes. You might be a stress eater or have concerns about the costs associated with diabetes.

You may also worry about how having diabetes will affect your family, your children and your future health. Let’s face it, all the complications and risks of having diabetes are quite scary and can certainly make anyone feel anxious.

Fatigue

All of these feelings, fears and the emotional roller coaster ride can lead to additional issues such as sleeplessness and general fatigue. Diabetes fatigue is a struggle — dealing with a chronic illness is just plain exhausting.

Medical Reasons for Mood Swings

As we saw above, there are many thoughts and feelings that go into having diabetes. While all of this can cause feelings of anxiousness and depression, there are physical causes of possible mood swings that you need to be aware of as well.

Low glucose levels (even just a low for you but still in the normal range) can cause a variety of symptoms including moodiness, anxiety, fatigue, confusion, dizziness, and blurred vision.

High readings for you, but still in the normal range, can also be a cause for similar symptoms. These highs and lows and the symptoms associated with them are why the goal for diabetics is to work with your doctor for a diet and medicine plan that will keep sugar readings as level as possible throughout the day.

Research has also shown that if you go for long periods with high blood sugar levels it can trigger the production of a hormone that has been linked to causing depression. So, when you take all the already emotional feelings surrounding diabetes and combine those with the physical reasons for mood swings, you can see why a diabetic may snap from time to time.

You May Also Like:Six Strategies for Coping With Diabetes Foot Pain

But, surely there has to be something to help all this of mental mess?

Yes, there are several things you can do to try and keep all of these balls juggling without hitting the ground. The following are our top six suggestions to keep mood swings at bay:

  • Work hard at a balanced carb diet. This will differ for each individual so be sure to talk to your doctor or dietician to understand what they are expecting from you.
  • Keep an emergency pack with you at all times in case of low blood sugar. This can come in the form of a granola bar, hard candy or glucose tablets. I keep some in my car and in my purse just in case I get stuck in traffic or at an appointment and can feel myself crashing.
  • Get off the couch. Seriously, if you have diabetes, it’s IMPERATIVE to incorporate some type of exercise into your day. Start slowly if you have to — even just walking in place in front of the TV will make a difference. If you’re tech-savvy, get a Fitbit or other step tracker. It’s fun to challenge your friends (and yourself) and see what you can do.
  • Yoga, meditation and mindfulness are really helpful at calming your emotions. There are many free meditation videos available on YouTube.
  • Track your sugar levels. If you are catching yourself in a mood and you know it, take the time to take a reading. If you can get a handle on whether you are going too low or too high in your counts, it will give you a better idea of how to solve the problem.
  • Talk to your doctor. If you are finding mood swings and feelings of depression/anxiety taking over your day, it might be time to get professional intercession. Your doctor can help you determine if your diet might be to blame, or if you need some depression medications, and they may even point you to a counselor to help you sort out your feelings.

Yes, diabetes is a burden and not an easy one to bare. But with education, careful planning, and some creative solutions, you can tackle the emotional roller coaster and ride with your hands up.

Low Blood Glucose Can Cause Sudden Trouble

If you tightly control your diabetes, it can be easier to accidentally slip into low blood sugar. And low blood sugar has more immediate, obvious effects on your brain than high blood sugar.

The symptoms of low blood sugar get worse the lower your blood sugar goes. It can affect your mood and make it difficult for you to think. You might get a headache, feel dizzy, have poor coordination, or have trouble walking or talking. Severely low blood sugar can give you seizures or convulsions, make you pass out, or put you in a coma.

Repeated bouts of low blood sugar can become problematic, says Gail Musen, PhD, assistant professor of psychiatry at Harvard Medical School in Boston.

“Going too low once in a while probably doesn’t have a huge long-term effect on the brain,” she says. But if you have frequent low blood sugar, you can become unaware of it, and it’s dangerous to live like that.”

This condition, called hypoglycemia unawareness, happens when your brain has trouble noticing low blood sugar levels. When that happens, you won’t get the usual early symptoms of low blood sugar, such as nausea, hunger, shakiness, cold or clammy skin, or a pounding heart.

Usually these symptoms are enough to wake someone with diabetes up from sleep, but if you have hypoglycemia unawareness, you might not wake up, and your blood sugar can continue to drop until it’s an emergency.

Hypoglycemia unawareness can also catch you off-guard while you are driving and lead to an accident, or cause you to fall.

The jury is still out on whether repeated bouts of low blood sugar can cause long-term memory problems or raise the risk of dementia. One large study, called the Diabetes Control and Complications Trial, showed that low blood sugar does not have a long-term impact on memory or the ability to think in people with type 1. But another study suggests a link between a history of severe low blood sugar and a higher risk of dementia in older people who have type 2.

The bottom line is that careful diabetes control is important, Zonszein says. “Low blood glucose might not make you get dementia, but it feels terrible. High blood glucose may not feel terrible, but it might cause problems with dementia.”

THURSDAY, May 17, 2012 (HealthDay News) — Many people know diabetes — both type 1 and type 2 — can take a serious toll on physical health. But these blood-sugar disorders also can affect your emotions and, in turn, your emotions can wreak havoc on your diabetes control.

Extremes in blood-sugar levels can cause significant mood changes, and new research suggests that frequent changes in blood-sugar levels (called glycemic variability) also can affect mood and quality of life for those with diabetes.

Depression has long been linked to diabetes, especially type 2. It’s still not clear, however, whether depression somehow triggers diabetes or if having diabetes leads to being depressed.

More recent research in people with type 1 diabetes has found that long periods of high blood-sugar levels can trigger the production of a hormone linked to the development of depression.

People with type 1 diabetes no longer can make their own insulin; people with type 2 diabetes need insulin treatment because their bodies can no longer produce it in sufficient quantities.

“Diabetes gives you so much to worry about that it’s exhausting. It can make you feel powerless,” said Joe Solowiejczyk, a certified diabetes educator and a manager of diabetes counseling and training at the Johnson & Johnson Diabetes Institute in Milpitas, Calif. “I think it’s important to acknowledge that, from time to time, you’re going to have a meltdown. You’re going to have days when you feel exasperated, frustrated, sad, in denial and physically exhausted.”

Solowiejczyk, who has type 1 diabetes himself, said these feelings become a problem “when you’re not able to get on with your life, and you’re persistently not taking care of your diabetes.”

Not only does diabetes increase the risk of serious health complications, but uncontrolled diabetes also may worsen depression, causing a vicious cycle.

In addition to an increased risk of depression, diabetes can affect mood even from minute to minute. For example, someone who experiences low blood sugar may suddenly become irritable, even combative, and may act as if they are drunk, slurring their words.

Low blood-sugar levels (also known as hypoglycemia) occur when someone has taken too much insulin or hasn’t eaten enough food. Exercise, alcohol and many other factors can lower blood-sugar levels unpredictably.

The problem, Solowiejczyk said, is “that the brain operates totally on glucose. When you don’t have enough glucose, things start breaking down and your cognitive function doesn’t work that well. This is a physiological, not an emotional, response.”

Dr. Vivian Fonseca, president of medicine and science for the American Diabetes Association, said, “Hypoglycemia reactions are very understandable. There are also some fluctuations that are not quite in the hypoglycemia range that may affect anxiety levels.”

High blood-sugar levels (hyperglycemia) also can lead to mood changes. “Hyperglycemia can affect your ability to concentrate and can make you feel grouchy,” Solowiejczyk said. “Any change in the blood sugar outside of the normal ranges makes you feel weird and uncomfortable.”

A small study in the April issue of the journal Diabetes Technology & Therapeutics found that frequent fluctuations in blood-sugar levels in women with type 2 diabetes were associated with a lower quality of life and negative moods.

Fonseca said, however, it’s important for these findings to be replicated in a larger population.

Although diabetes and blood-sugar levels can affect emotions, emotions also can affect patients’ blood-sugar levels and diabetes control.

In another study in the same journal issue, researchers tested blood-sugar levels in non-diabetic bungee jumpers, and found that the stress of the jump caused their blood-sugar levels to rise significantly. Not surprisingly, their stress hormones also were higher due to the body’s normal fight-or-flight response. When this happens, the liver releases glucose to make energy available to the body’s cells, according to the American Diabetes Association.

People with diabetes don’t have sufficient insulin to let that glucose into the body’s cells, however, so instead of providing energy, the sugar just builds up in the blood.

Another emotional minefield often associated with type 2 diabetes is the concept of blame. Most people with type 2 diabetes are overweight, and many are sedentary. Being overweight alone, however, doesn’t cause type 2 diabetes. There are other factors, such as a genetic predisposition, at play. But because exercise and losing weight can help prevent — or, in some cases, reverse — type 2 diabetes, society often blames people with the disease. (Type 1 diabetes is an autoimmune disease that is not caused by diet or lack of exercise.)

“I think there is a prejudice against overweight people and people with type 2 diabetes, and that’s something they have to deal with,” Solowiejczyk noted.

What’s important, he said, is that if you’re persistently having trouble dealing with any of the emotions that come with diabetes, you talk with your doctor, diabetes educator or therapist.

“You should be feeling bad or resentful or angry sometimes,” he said. “Diabetes is hard, and all of those feelings come along with the disease. But if you’re and angry or if you’re sad all the time, you’re not going to take care of yourself.”

The same advice is true for partners of people with diabetes and parents of children with diabetes, he said.

More information

Learn more about the emotional side of diabetes, and the signs of depression, from the American Diabetes Association.

How Diabetes Impacts Mental Health

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