Decision Fatigue Can Lead to Diabetes Burnout

Having diabetes requires making lots of decisions every day to stay well. The pressure can be overwhelming. Throughout the day, you may find yourself:[1]

·         Making food choices, which involves counting carbs and managing portions

·         Choosing the right exercises since activity can affect your glucose

·         Adjusting insulin for meals, stress, other health problems, and an unexpected change in your schedule, which can impact when you take your insulin

While technology, such as Continuous Glucose Monitors (CGM), which estimate blood glucose levels throughout the day, can be extremely helpful; the devices still need human intervention. You need to know how to respond to alarms, calibrate the devices and maintain settings on the pump.

Constant decision making, in addition to worrying about potential health complications such as heart disease, vision loss or kidney issues, can cause anxiety and mental strain and result in diabetes burnout.  You may feel exhausted and drained. This can lead to disengaging from daily diabetes management. Diabetes burnout can impact other areas of one’s life, including productivity at work.

Stress makes diabetes management more challenging

Chronic stress is at the heart of burnout. Making matters worse, when you are under stress, your body releases hormones that can cause blood sugar levels to increase, making it more difficult to stay within your target range. Stress can lead to unhealthy behavior, including poor eating habits or smoking, which can result in high blood pressure, heart disease and obesity. These conditions can make managing your diabetes even more challenging. [2]

Dealing with a life-threatening illness such as diabetes can even result in depression, which results in poorer health outcomes. The CDC reports that people with diabetes are 2 to 3 times more likely to have depression than people without diabetes. Only 25% to 50% of people with diabetes who have depression are diagnosed and treated. But treatment—therapy, medicine, or both—is usually highly effective. And without treatment, depression often gets worse, not better. [3]

Research on diabetes burnout

In 2019 researchers conducted a study[4] to increase their understanding of diabetes burnout among adults with the condition. Research involved eighteen adults who had Type 1 diabetes and reported a current or previous experience of diabetes burnout. The study involved conducting in-depth reviews.

Researchers looked at the following: mental, emotional, and physical exhaustion from the disease; detachment from illness identity, diabetes self-care, and support systems; factors contributing to diabetes burnout; and strategies for preventing or overcoming diabetes burnout.

Researchers concluded that detachment is an entry point for diabetes burnout. However, detachment from illness, self-care and support systems form a core component. They found detachment may explain poor outcomes in individuals experiencing burnout.

Other research published in 2021 involved a research review[5] aiming to summarize conceptualizations of burnout in individuals with diabetes and describe its adverse outcomes as well as proposed mechanisms of action and targets of intervention. Findings included identifying adverse long-term outcomes of diabetes burnout, including:

·         poor treatment compliance

·         diabetes complications

·         depression

The review found diabetes burnout may result from sustained cognitive stresses of adhering to chronic treatment, assessment of realistic treatment goals and treatment challenges. Researchers advised early screening and interdisciplinary approaches for patient-centered diabetes care are critical for sustained diabetes social support.

Symptoms of diabetes burnout

Common signs include:

·         feeling unable to cope with diabetes

·         feeling powerless

·         feeling tired all the time

·         having difficulty sleeping

·         feeling more stressed, anxious, or sad

·         removing oneself from social support

·         losing interest in activities previously enjoyed

·         failing to keep up with regular medical checkups

·         missing our skipping medication, such as insulin

·         not monitoring glucose levels as often

·         not following proper diet

·         not engaging in exercise

·         ignoring or trying to forget about diabetes

·         concern over finances

You also may have physical symptoms. You may experience headaches frequently, muscle or joint pain and a loss of appetite. Your symptoms may even include nausea, digestive issues, chest pain and panic attack.[6]

Coping with diabetes burnout

Taking care of diabetes will be constant but there are things you can do to lessen the burden of managing it.[7]

·         Talk to your medical team: Let your doctor and other medical professionals who are part of your care team know how you feel and the challenges you are facing. They can help produce a plan to make dealing with the disease more manageable.

·         Change your perspective: Consider ways to make managing your diabetes easier. For example, set reminders on your phone to check your blood sugar so that you do not have to think about it.

·         Be with supportive people: Join a diabetes support group. People with the same feelings and challenges can help ease the burden of managing diabetes.

·         Ask for help: Enlist friends and family members to help you remember to take your meds or check your blood sugar. Find a friend to join in daily exercise, such as taking a walk.

·         Streamline your treatment: Automate what you can, set up recurring shipments of supplies to avoid having to remember placing orders, schedule medical appointments in advance and set reminders on daily calendars.

·        Be easy on yourself: Managing diabetes is hard. Be easy on yourself. Allow yourself time to pause and reset when you are feeling overwhelmed.

·         Practice stress relief: Lower stress and improve focus by doing things you enjoy, exercising and being with people you care about.

Do not let diabetes burnout affect managing your condition. Take the right steps, get support and use tools to help management. You can take charge and regain motivation to keep diabetes under control and have good quality of life.