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Panic Disorder Or Hypoglycemia?

A study led by L.S. Griffith in St. Louis indicates that some patients with diabetes who believe they are having hypoglycemic incidents are actually suffering from a panic disorder.

Nineteen subjects who had had diabetes for 13 years or longer participated in the study. All had reported increasingly frequent hypoglycemic incidents, although the memory files in their glucometers did not indicate any readings below 200 mg/dl. All the subjects were treating their perceived hypoglycemia with 300-500 calories. In the course of eight weeks, the subjects were given either placebos or alprazolam, a minor tranquilizer used to treat anxiety disorders.

Three subjects were eventually diagnosed with panic disorder, but two dropped out of the study because they did not accept a psychiatric explanation for their symptoms. The 22-year-old male who remained completed eight weeks of active treatment with alprazolam. Initially he experienced anxiety, heart palpitations, shortness of breath, dizziness, trembling, and sweating. He never registered a blood glucose level under 200 mg/dl during this time, but continued to believe he was hypoglycemic and treat himself with 300-500 calories. After eight weeks of alprazolam therapy without adverse side effects, he experienced decreased symptoms and a 1.6% reduction in A1c.

Griffith concluded that hypoglycemia may not always be identified by symptoms alone and may require a blood glucose measurement to rule out panic disorder.

This research was presented at the 22nd Annual Meeting and Educational Program of the AADE in Boston, August 1995.

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