A woman puts her hand on her face (Photo: ShutterStock)
People living with diabetes know very well that their main goal is to 'stay balanced', meaning that their blood sugar levels will be normal.
Still, sometimes this balance is violated, and the patient may reach extreme conditions such as hyperglycemia (very high levels of sugar in the body) or hypoglycemia (a sharp drop in blood sugar levels).
Hypoglycemia occurs when the blood sugar level drops to less than 70 mg. This is a phenomenon that almost every diabetic is familiar with, and in many cases it passes relatively easily. However, there are also cases of severe and life-threatening hypoglycemia, which is characterized, among other things, by the need for immediate human assistance Another, since it is an acute experience of loss of control.
Since it is a shocking experience of helplessness, such a hypoglycemic event may leave the diabetic patient in significant trauma.
Omer Shaked, a clinical social worker at the Endocrine Institute in Tel Hashomer and a lecturer in social work at Bar-Ilan University and the Central School of Social Work of the Ministry of Welfare, explains that in most cases even a severe hypoglycemic event will not necessarily turn into a crisis event. Support circles near the event, may become a significant trauma for the patient with long-term consequences.
"Sometimes a hypoglycemic event can be dangerous, and when it becomes dangerous - the situation can be considered a traumatic event," explains Shaked, "it's not always traumatic and there are many variables. There can be a diabetic who gets hypoglycemic while walking down the street, but he received a lot of support and help. Despite the fact that he was In a life-threatening situation, the event will not have emotional consequences of the most serious severity. It depends on how the situation develops and the support resources," he adds, "but, unfortunately, there are also cases where there is not enough support. For example, a woman who was in another country and fell in a foreign place And she couldn't get help, she didn't know who to turn to and thought she would die there on the street - it will be difficult for her to recover from that," he explains.
When the fear stems from something inside your body - it's hard to recover from it
It is important to note that the risk of a traumatic event varies greatly between the types of diabetes, and people with type 1 diabetes, especially the younger ones, have a greater risk of suffering from very severe hypoglycemic events that leave scars.
"If someone was 11 years old when she had a severe hypoglycemic episode, that is very different from a 42-year-old person with type 2 diabetes who has already developed mental resilience," explains Shaked, "a girl should not have to bear the understanding that her life was in danger. And this is where the distinction between the types of diabetes comes in. Diabetes Type 2 usually comes at a later age, and the patients already gain more life experience. If there is a diabetic child who has had many episodes of hypoglycemia throughout his life - that is a different situation."
In addition, severe hypoglycemic events in type 2 diabetes are less common, and a healthy lifestyle helps maintain balance, but type 1 diabetes has no cure.
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"A girl should not bear the realization that her life was in danger."
A mother does a sugar test for her daughter (Photo: ShutterStock)
"This is where another element comes in," Shaked adds, "If a person goes through a car accident, with the right support, he can continue again and know that tomorrow life will return to its course, but for a person with type 1 diabetes, the cause of the traumatic event is internal," he explains, " If I talk to a child who is afraid to go out after severe hypoglycemia, he is largely right, the source of his fear is internal and I cannot tell him that he has nothing to fear. We all do not have complete control over life, no one is guaranteed anything, but it is still different, the mechanisms of the reasonable person can help him bear the experience of uncertainty and lack of control, this is part of being a living being, but with diabetes the level of risk is different, the danger is constantly within him, when there is a constant confrontation with an experience of lack of control, this is one of the signs of a traumatic event" .
Shaked adds that this is the reason that when a person goes through such an experience there is great difficulty in getting life back on track, especially if there is no support and if that patient does not lean on supportive circles around him.
According to him, it is so important that people who are close to diabetics who go through such experiences understand their complexity.
"The underlying anxiety can be very great, and life for a diabetic who has had an event or several difficult events is a different life experience than yours or mine," stresses Shaked, "and it's built-in, you can't give it up. A person after an accident can get rid of the car, a diabetic Can't just get rid of the pancreas."
When you are afraid of the only medicine that can help you
The cause of severe hypoglycemia is a drop in sugar levels, and in some cases diabetics are so afraid of it happening again that they make dangerous decisions.
"They may decide that they will no longer approach a low sugar level, and this may cause them to give up things in life that can be experienced as unsafe because the sugar can drop, such as going to school or leaving the house, to the level of functional impairment," Shaked explains, "It can Expressing myself as giving up treatment for diabetes, thinking that if what causes me to lose control is a low level of blood sugar, and insulin lowers blood sugar, then I give up insulin to get away from the danger - this is terrible and terrible, and very dangerous. It is an existential suffering and a very difficult trap crack it without personal and therapeutic work."
Hypoglycemia is similar to an anxiety attack, which is dangerous.
A woman lying on a sofa (Photo: ShutterStock)
And another important thing to know is that the symptoms of hypoglycemia and the symptoms of an anxiety attack are very similar, and this too can cause dangerous choices.
"From my conversations with diabetics and the preparatory work we did at the Endocrine Institute, there are several symptoms of severe hypoglycemia: blurred vision, difficulty concentrating, palpitations and shortness of breath, nausea, weakness in the legs, and these are really the symptoms of an anxiety attack, one by one," explains Shaked, " This means that if a diabetic went through such an event and had the symptoms, it is very possible that he is at a level of fear, which can cause an anxiety attack, 20 percent of the population goes through such an attack during their lifetime, but with the diabetic patient the attack is justified because it is based on something internal that produces anxiety" .
And this similarity in symptoms is very problematic.
"Here the work of the diabetic becomes even more difficult, because he does not know what is going on, has difficulty trusting the device and the measurements, the internal perception becomes unreliable," says Shaked, "there is somatic confusion, the physical experience of a drop in diabetes is similar to the experience of an anxiety attack, And it is a very complex vortex, and it creates a situation of difficulty that I do not know like, as a patient told me that he is a prisoner inside his body, an experience of freedom that is fatally taken away, for the simple reason that there is nothing they did wrong, they were simply born with this body."
Don't stay with it alone
The most important thing after a severe hypoglycemic event is not to be left alone, to get help.
"If there is a support team, a social worker or a psychologist who can support, the chance of success is excellent, but if not then the event can turn into varying degrees of trauma," Shaked explains, "If this happens to you, pick up the phone, find a professional, and realize that it is something that is possible Deal with him successfully."
The contact for support should be made as close to the event as possible.
"As time goes on and no answer is given, the matter gets complicated. If someone comes to me after 20 years, it's more difficult," explains Shaked.
Still, it's important to remember that "something can always be done, and the motto here is not to lose hope, but on the contrary - diabetics know how to deal with life better than everyone else, and you can find ways to get through that too. But it's work, and don't expect it to be easy." He adds and emphasizes that for him there is true heroism in the day-to-day dealings of diabetics.
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Tags
diabetes mellitus
trauma
