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Anxiety, Diabetes, and the Art of Not Freaking Out - The Diabetes Link

Written by Allison Nimlos LMFT CDCES | Dec 23, 2025, 5:00:00 AM

Ahhh, anxiety. As a licensed therapist and fellow T1D, I like to think of Anxiety as a misguided BFF. It desperately wants to keep an eye out for you, but it often ends up overreacting—or is just way off base about what’s actually a threat. Anxiety is all about creating safety, but it fails magnificently because it hyper-fixates on things that are incredibly unlikely to happen.

Anxiety & Diabetes

Anxiety shows up in so many areas of life, and diabetes is no exception. Anxiety hates the unknown and uncertainty, because it doesn’t know if we’re safe. Some common place you might notice Anxiety: 

  • When our blood sugar is dropping, we think about passing out
  • When our blood sugar is rising, we fixate on potential complications.
  • When our CGM alarms in class or a work meeting, we wonder if we are bothering people or being judged
  • When someone invites us to do something, we second-guess our ability to manage our BGs and not be a burden on others

Plus, the constant monitoring of blood sugar, carbs, and meds creates an easy doorway for Anxiety. We’re always scanning for problems, which can start to feel like we’re never safe—and remember, Anxiety does not like not being safe.

It tries to create safety wherever it can, even if that means doing things (like eating extra food or taking less insulin) that actually make us unsafe. It’s a sticky situation: we feel like we’re doing the “right” thing, but we end up making everything harder.

Anxiety or Low Symptoms?

To complicate things further, anxiety in our bodies can mimic the symptoms of low blood sugars. Some common physical symptoms include:

  • Heart racing
  • Shaking
  • Sweating
  • Trouble sitting still
  • Trouble concentrating
  • Sleep disruptions

This is why it’s so important to check blood sugar with a CGM or meter instead of treating our feelings as fact. 

So what can we do when we notice Anxiety trying— ineffectively—to protect us from life’s unknowns?

Name the thought.

“I’m having an anxious thought. Anxiety is telling me XYZ. What I’m experiencing is anxiety.” This simple step builds mindful awareness of what’s actually happening.

Deep breathing.

Techniques like box breathing can help your body regulate during stress and clear your mind:

  • Breathe in through your nose for 4 seconds
  • Hold for 4 seconds
  • Exhale through your mouth for 4 seconds
  • Wait for 4 seconds
    Repeat as needed.

Identify the best response.

Anxiety always has an opinion about what you “should” do, but what do you think? Anxiety may be loud, but that doesn’t make it right.

If deciding in the moment is tough, some proactive self-exploration can help. Think about the situations that trigger Anxiety—pre-bolusing, taking more than X units, managing diabetes around others—when you’re calm. Decide what your actual priorities are in those moments.

This helps separate your thoughts from Anxiety’s thoughts.

Review the results.

How do things turn out when you listen to Anxiety? What happens when you follow your own values instead? You’ll often find that your decisions lead to better outcomes than Anxiety’s scare tactics. Over time, this builds real evidence you can lean on when Anxiety starts shouting again.

Anxiety may still show up, but the more you practice these skills, the easier it becomes to spot when it’s driving the bus. You deserve to be the one in charge—not Anxiety. With awareness, practice, and compassion for yourself, you can build a healthier, calmer relationship with both diabetes— and your mind.