This is an abridged version of an article first published in a newsletter for people with diabetes in Townsville that Donna writes. For more info, please email her.

There seems to be very little written about anxiety and diabetes. There is a lot written about stress, but little about anxiety. The textbook definition of stress is: The body's response to perceived or real danger - that flight or fight response. The definition of anxiety is: The state of being anxious; Distress of mind; Disquietude; Uneasiness; Misgiving; Apprehension; Eagerness.

Worry About BSLs And Control
I have observed in my own experience and in those of other people with diabetes, a tendency towards added anxiety about blood sugar levels. This anxiety is secondary to the disease, but potentially just as debilitating. Because control is dependant on a balance between insulin, food and exercise (not to mention stress and hormone levels etc.) it is possible to worry about every facet of human existence and its relevant effect on blood sugar levels.

Diabetes can be a socially unacceptable disease. Every new diabetic must learn how to inject himself or herself and do awkward bloodletting experiments in public. If you decide to go undercover, you must deal with the anxiety of maintaining your cover, and keeping your secret. If you tell the world, you must cope with naive and often ignorant expectations and the prying eyes and the judgements of others. If you are a "people pleaser" like me, you may worry that your HBA1c is not going to please your doctor. Your diet falls short of the dietician's recommendations; you stop eating in meetings to please your boss; then you eat double the sweets to accommodate the hypo, and please yourself (only to become more remorseful later).

Worry About Hypos
In my first weeks back at work as a newly diagnosed diabetic, I remember being chastised by my boss for creating a distraction during staff meetings by testing my BSL in the middle of the meeting. What she did not realise was that I was acutely anxious and fearful of hypos and had trouble distinguishing whether my feelings of anxiety were hypo related or just anxiety related (since the symptoms are often similar - i.e. sweaty fingers, nervousness, shakiness etc.)

Under the category of "Worry About Hypos" or "WAH" for short, there are hundreds of untold examples of interruptions to everyday life that a non-diabetic need never worry about. One of the most annoying is WAH during sport. How ridiculous that you go to aerobics to lose weight, only to find you have to grab a Mars bar before the class is finished! Or at half time you are so madly trying to check your BSL that you fail to get back on the field in time for the kick off. Even the partners of diabetics suffer from WAHs. My husband would worry while I was on the back of the motorbike on long trips.

Worry About Complications
Worry about Complications has robbed many a diabetic of appreciation of the here and now. Many people needlessly worry about things that may never come to pass. Even though it is quite possible that we will suffer from complications due to diabetes, worry in itself will not make any difference to our future predicament.

I have worked through a few solutions to anxiety and diabetes. Here are a few ideas:

Get Support
Talk to someone else who has diabetes. They know what you are talking about. (This is why I am writing this article!)

Write Down Your Worries
They are often not as "big" when they are on paper, and you can often make more rational solutions when the problem is clarified on paper.

Knowledge Is Power
The better you know your body's reactions, the more in control you will feel. For instance, when at aerobics, I know there is a huge difference between a low impact and high energy work out in terms of hypos.

Assertiveness, self- esteem and self-control are not automatically granted to the diabetic along with the disease! These are things we need to learn or adopt along the way. The secret is, I think, to realise that no-one is perfect and that it's OK to seek help, rather than worry and do nothing about it.

DON'T WORRY
Lying awake at night won't change a thing. Setting goals, and trying different behaviours to work towards solutions can make a big difference in reducing the anxiety that often accompanies the diabetes.