[Comorbidity of hypoglycaemia anxiety and panic disorder in a patient with type-1 diabetes - Combined treatment with cognitive-behavioral therapy and Continuous Glucose Monitoring (CGM) in a psychosomatic day-treatment center].

Clinical History And Findings: A patient with T1DM, panic disorder and hypoglycaemia fear diabetes duration 4 years, BMI 25. 6, was treated in the day clinic psychosomatics with a multimodal treatment approach. She reports severe fear of hypoglycaemia and repeated hypoglycaemia. Fearing hypoglycaemia, the patient changed her diabetes self-management and thus experienced limitations in her everyday functionality.

Diagnosis: Diabetes mellitus type 1, panic disorder and exaggerated fear of hypoglycaemia.

Therapy: The combination of continuous glucose monitoring (CGM) and a symptom record diary from classical cognitive-behavioural therapy (CBT) and in addition a multimodal psychotherapeutic group intervention based on Acceptance and Commitmenttherapy (ACT) were applied. The patient learned to differentiate between symptoms of panic attacks and symptoms due to low blood glucose levels.

Conclusion: The combination of psychotherapeutic measures with CGM appears to be a helpful approach to the treatment of disease-specific mental disorders in diabetes mellitus.