People with diabetes often experience mood swings, usually indirectly due to the internal hormonal and vascular variations triggered by blood glucose fluctuations. These mood swings, especially the irritable and more angry versions of it, are often collectively described as diabetic rage.
“Diabetic rage is not a medical term, but a simple term referring to anger,” says Dr A. Sharda, Consultant- Endocrinologist and Diabetologist, Manipal Hospital, Millers Road, Bengaluru.
What is diabetic rage?
Dr Mahesh DM, Consultant- Endocrinology- Aster CMI Hospital, Bengaluru says that diabetic rage describes the mood swings experienced by a person with diabetes. He also adds that fluctuations in their blood glucose level affect the chemicals in the brain causing mood disorders. It is also quite common in children.
“Some people do not accept their diabetes diagnosis. I have come across people, whose families have said that they have generally been irritable even before the diagnosis, and this has just made it worse. The affected people also do not like being associated with diabetes,” says Dr Ritika Aggarwal, Psychiatrist, Jaslok Hospital, Mumbai.
What causes diabetic rage?
Glucose (sugar) levels
Blood sugar variations are known to have a direct impact on our stress hormone, cortisol. When blood sugar goes up, cortisol levels also tend to increase.
“When there are episodes of low sugar or high sugar, it increases the production and secretion of the stress hormone, cortisol. This can lead to anxiety or even depression. All of this together can also add to the feeling of frustration,” says Dr. Aggarwal.
Experts also point out that there is a direct correlation between high sugar, anxiety and anger.
“Even after patients accept their diagnosis, if their sugars are high, they can experience anger,” said Dr Sharda.
Psychological reasons
“From a psychological perspective, it happens because of frustration and resentment. There is a lot of fear and uncertainty about health and lifestyle limitations that comes with being diagnosed with diabetes,” says Dr Aggarwal. For instance, they have to eat at a specific time or won’t be able to eat out with people, which interferes with work and lifestyle. A lot of patients have anger, frustration, irritation and stress, related to the diagnosis. Diabetes is also a very expensive condition to manage.
“Diabetes is a long-term disorder that can only be controlled but not cured. The first reaction of humans to long term diseases that cannot be cured is denial, which itself can cause rage,” says Dr Sharda.
Dr Aggarwal adds that, it can also happen because of the feeling of being stuck in one place, not knowing how to move forward, or how to change your lifestyle accordingly.
Dr Sharda explains how she came across a patient who consulted 5 doctors in 3 weeks even with a sugar of 400 mg/dL, 450 mg/dL and 500 mg/dL, because of denial. Denial of a long-term disease such as this can cause rage and anger.
Symptoms of diabetic rage
“Depending on the symptoms, we can tell if it is happening because of psychological reasons or glucose fluctuations,” says Dr. Mahesh.
Dr Aggarwal adds that violent outbursts including physical violence, impulsive and aggressive behaviour are other prominent symptoms.
How to cope with diabetic rage
Dr Aggarwal explains that any new diagnosis comes with its own cycle of grief. It is important to accept the diagnosis and know it is normal. Following what the doctor has told you regarding diet, sleep cycle, lifestyle, etc., will make it better.
Despite doing all of this, if a person with diabetes still finds it hard to accept the diagnosis or work through the anger issues, anxiety or depression, they should seek the help of a mental health practitioner.
“People with diabetes experiencing rage, hunger or depression should understand that it might be related to diabetes and talk to a mental health practitioner or a physician to help them identify the problem,” says Dr Sharda.
Diabetic rage and glucose monitoring
They can also use glucose monitoring devices to regularly check their sugar levels. It is also important to inform their colleagues and families that they have diabetes.
“60-80% of it can be regulated through a monitoring system, either through glucose meter or correlating their mood to the sugar levels, so they can have an insight into it,” says Dr Sharda.
If a stable blood sugar level is maintained, the risk of mood swings could be reduced.
Takeaways
People with diabetes are often subjected to mood swings, often directly due to blood glucose variations or indirectly due to the internal hormonal and vascular variations triggered by diabetes. Experts opine that apart from a strict diabetes management routine, they could also be helped by their friends and family by offering strong and positive emotional support and motivation to stick to their diabetes management course.