Recognizing Burnout from Diabetes

If you have diabetes, you know that living with the disease can be a daily battle – and one that often seems uphill. Daily self-management of the disease can include glucose testing, foot care, exercise, dietary changes/food preparation, and taking multiple medications. The prospect of long-term serious complications – heart and kidney disease as well as peripheral neuropathy and vision loss - as well as concern over the quality and cost of medical care can add to the emotional burden of the disease resulting in “diabetes distress.”

Compounding what is already a stressful situation is the stigma that comes with having a chronic disease. Facing discrimination – whether overt or covert – and the reaction of others adds to the burden of the disease. People may have thoughtless reactions or attempt to provide unhelpful advice because they do not understand the disease.

Diabetes distress is common

Diabetes distress refers to the worries and fears of living with and managing diabetes. Diabetes distress is not clinical depression, but it can co-exist with depression, which is a mental health condition. About 40% of adults with either Type 1 or Type 2 diabetes report significant distress at any point in time, and over 50% report significant distress during any 12-month period. [1]

Diabetes distress includes such symptoms as:

·         feeling emotionally upset about having the disease

·         feeling overwhelmed living with diabetes and managing it

·         feeling frustrated

·         worrying

What is diabetes burnout?

Diabetes burnout may co-exist, and share the same symptoms as diabetes distress, but it is not the same. Stress is someone’s natural response to everyday stressors, such as those associated with diabetes daily management. You may experience stress for a while, or it can become chronic.

However, over time, stress can lead to burnout. Diabetes burnout is the emotional and physical exhaustion resulting from the challenges of living with and managing diabetes, which never lets up. Sticking to daily regimen can become tiresome and impact other areas of one’s life, including productivity at work. A person may have unrealistic goals about treatment, such as expecting to meet target blood glucose levels or meeting daily exercise requirements. Support from friends and family may be lacking. These factors, coping with complications and with the anxiety and depression that come with having a chronic disease can trigger diabetes burnout. A person may disengage from taking care of their diabetes.

Research looks at diabetes burnout

Diabetes burnout can lead to neglecting day-to-day disease management and wanting to give up.

In 2019 researchers conducted a study[2] to increase their understanding of diabetes burnout among adults with the condition. Research involved a qualitative descriptive study with a sample of eighteen adults with Type 1 diabetes who reported a current or previous experience of diabetes burnout. The study involved conducting in-depth reviews.

Researchers identified four main themes from the study: 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 although detachment is an entry point for diabetes burnout, 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[3] 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

Diabetes burnout symptoms

While diabetes burnout symptoms may vary, common signs include:

·         feeling unable to cope with diabetes

·         feeling powerless

·         feeling tired all the time

·         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

·         feeling overwhelmed by managing the disease

·         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

Impact of diabetes burnout on well-being

Diabetes burnout symptoms can impact on your physical well-being if you neglect keeping track of your blood sugar levels, disregard recommended eating habits and skip medication. By not managing blood sugar levels, you may have other health problems. And your mental health may suffer if you have trouble concentrating and making decisions.

Diabetes burnout also may seriously impact quality of life if you lose enthusiasm and motivation to do things you previously loved to do. Connections with friends and family also may suffer.

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.[4]

·         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.

Burnout should not derail diabetes management. It is challenging to stay on top of medicines and other day-to-day requirements. But asking for help, setting up systems so that management is more automatic and streamlined and allowing for the occasional slip up in day-to-day tasks make it possible to avoid burnout.