Some things many of us do daily for self-care may eventually become automatic, like preparing healthy meals, taking our vitamins and so on. But what happens when the list of things a person needs to do to keep themselves well and healthy becomes longer and more time-consuming?
For people with diabetes, managing the disease can involve testing their blood glucose levels, taking medication, meal planning and cooking healthy food, getting regular exercise and physician appointments. Experts say the stress of the time and effort involved in self-care can lead to what is commonly known as diabetes burnout.
We talked to Betsy Richter-Gifford, inpatient diabetes specialist at Texas Health Arlington Memorial Hospital, about what diabetes burnout is and why it occurs.
“Diabetes is a disease of SELF-management that requires constant attention 24 hours a day, 7 days a week, 365 days a year by the person living with it,” she explains. “You are constantly juggling medications, blood glucose monitoring, nutrition, physical activity and stress — all factors that impact your blood glucose levels — in order to maintain blood glucose levels in the target range. Diabetes is also an extremely expensive disease to live with. For all these reasons, living with diabetes can be VERY exhausting.
“Diabetes burnout happens when you grow tired of managing your disease and in some cases, neglect self-management skills. Diabetes burnout can be unique to the person experiencing it and may come in many forms. Some people may feel ‘sick and tired’ of doing everything, while others just don’t care about their diabetes anymore and want to give up. Unfortunately, ignoring diabetes can have very serious short and long-term health consequences.”
When a person with diabetes gets becomes stressed, anxious or depressed due to the challenges in managing his disease, he is experiencing diabetes distress. In an article published by the American Diabetes Association about diabetes distress, researchers reported that in any 18-month span, 33 to 50 percent of people with diabetes will experience diabetes distress. This statistic is troublesome because diabetes distress leads to poor emotional health, physical health and health outcomes.
Glucose levels and diabetes distress seem to negatively play on each other, as higher glucose readings increase the incidence of distress, while higher distress can lead to increased glucose levels. As a result, a person may decide he can’t do anything about his diabetes (burnout), so he gives up trying to manage it (distress).
While it’s not guaranteed that every person living with diabetes will experience burnout, Richter-Gifford warns it is very common.
“I think everyone living with diabetes will experience diabetes burnout at some point in their journey,” she says. “The key is to identify these feelings and find healthy ways to cope with them. I try to help my patients identify their personal motivators for diabetes self-management. I find they are more successful when they connect diabetes self-care to something in life that is meaningful to them. For example, when a patient sees that their focus and coordination is better on the golf course with blood glucoses in the target range, that can make a huge difference.
“As diabetes professionals, we try to help people living with diabetes stay motivated rather than striving for perfection. We help people identify barriers and find ways to overcome them. When living with diabetes, it is important to get support from family, friends and coworkers and connect with others by joining a local diabetes support group.”
Diabetes burnout and distress can occur in people with Type 1 and Type 2 diabetes, so it’s important to watch for signs in yourself or your loved one living with diabetes. In an article on burnout from non-profit organization Beyond Type 1, burnout is characterized by the following signs and symptoms:
- Feeling sad, angry, frustrated or overwhelmed by your diabetes
- Feeling controlled by the disease
- Feeling isolated, or like nobody understands what you’re going through
- Feeling a lack of motivation to manage your diabetes
The organization recommends managing realistic expectations; making small, sustainable changes to improve self-care; and seeking support to prevent and/or overcome diabetes burnout.
Richter-Gifford says being open and honest about your feelings and communicating with family and healthcare providers are the best ways to stay on track.
“Feelings of diabetes burnout are very common, perfectly normal and certainly something you can overcome or manage,” she says. “Diabetes impacts the whole family, so it is important to communicate about these feelings. For loved ones supporting someone living with diabetes, your approach is vital to the person experiencing diabetes burnout. Come from a loving, caring place rather than in a judgmental, shaming way.
“Ask your loved one with diabetes how you can help to support them. Acknowledge their feelings of exhaustion and frustration from living with this disease. You can’t scare someone into managing diabetes, but research shows that maintaining blood glucose in the target range is one of the biggest ways to lower the risk of long-term complications from this disease.”
Whether you’re starting to suspect diabetes burnout or experiencing full-blown distress, it’s time to ask for help!
“If you are experiencing increasingly negative feelings about your diabetes self-care, know that it’s okay and normal, but don’t just ignore it,” Richter-Gifford says. “If it’s getting in the way of successful self-management at home, you may need to be re-energized. Meeting with your diabetes educator can help you re-focus and regain perspective. We can help you make a plan to get back on track and be successful in your diabetes self-management before it has a serious impact on your health.”