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This post was written by Alexandra M. De Lellis, NP, Parkview Endocrinology.
Research published by the American Diabetes Association (ADA) reveals that 1 in 4 individuals with type 1 diabetes and 1 in 5 individuals with type 2 diabetes experience diabetes distress. This state of emotional exhaustion is often triggered by the multifaceted challenges associated with managing this chronic condition. Here, we'll explore how the ongoing demands of diabetes can lead to burnout, what signs to look out for in someone struggling and how to provide help.
The physical and mental toll
Managing diabetes can be overwhelming, especially when insulin is part of daily care. The need for continuous monitoring, maintaining a healthy diet and managing medications are all part of the constant effort to keep glucose levels stable. However, failing to do so can lead to serious health issues.
Improperly managed high or fluctuating blood sugar levels can cause brain fog, low energy, weakness and inflammation throughout the body. Furthermore, overnight blood sugar variability can negatively impact sleep quality, which is critical for regulating stress, cortisol levels and mental clarity.
Ironically, the physical toll caused by uncontrolled blood sugar levels can make it challenging to participate in lifestyle choices that decrease insulin resistance.
There is also a significant psychosocial impact with diabetes as well. Many people with diabetes also live with comorbid anxiety and depression. Symptoms of both conditions can worsen with fluctuating or persistently high blood glucose levels.
Additionally, concerns about discrimination stemming from public misconceptions about diabetes, combined with patient experiences of feeling judged by healthcare providers for poor blood sugar control, can exacerbate diabetes distress.
Diabetes burnout
The physical and mental health factors that cause diabetes-induced stress can make it harder for people to take care of themselves. This vicious cycle, in turn, leads to poorer blood glucose control and diabetes burnout.
Diabetes burnout refers to feelings of physical or emotional exhaustion and frustration related to the daily demands of disease management, which can result in a decline in self-care behaviors.
Signs of diabetes burnout include:
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Disconnection from concerns
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Feelings of hopelessness
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Isolation or sharing negative or self-blame thoughts
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Disengagement from self-care tasks
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Unhealthy or uncontrolled eating
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Non-attendance at clinic appointments.
In many situations, patients are aware of the potential adverse outcomes of poorly controlled diabetes and report feeling shamed by those around them if their blood glucose levels are not at goal. These situations can serve to worsen diabetes burnout and feed into the negative self-care cycle.
Solutions for managing burnout
It is essential to recognize the physical and mental toll that uncontrolled diabetes can take. A comprehensive approach to addressing both issues can help improve outcomes and patient quality of life.
What patients can do
People with diabetes should advocate for themselves with their healthcare providers. These conversations can include discussing their care needs and treatment options for any comorbidities. It is important to find a balance between medication management to treat mental health and ensure it does not lead to worsening blood glucose control. Certain common antidepressants, tricyclic antidepressants, and some stimulants used to treat ADHD and other mental health issues can worsen blood glucose control and lead to insulin resistance.
Community-based support significantly affects health perceptions and self-care for individuals with diabetes. This includes social media community groups, therapist-led group diabetes support and one-on-one therapy. Mental health therapists specializing in care for patients with chronic conditions can also be beneficial.
In addition to mental health support, it's essential to maintain regular physical activity, a balanced diet and good sleep hygiene for managing blood glucose levels. When burnout makes it challenging to uphold these habits, try to focus on smaller, manageable actions. Remember, progress is about sustainability, not perfection.
Find more helpful tips in these posts from the Parkview Dashboard:
The keys to feeling confident about your health decisions
Coping with sadness following a diabetes diagnosis
Getting back to the basics of diabetes care
Finding balance after a diabetes diagnosis
How to overcome common diabetes self-care barriers
Empowering patients through education
How healthcare providers can help
When evaluating uncontrolled diabetes, providers should seek to monitor for signs of diabetes burnout. Even if A1C or blood glucose levels are within target, this does not mean the individual is free from diabetes distress. Many patients report that when providers address their blood glucose levels with patience and compassion, it leads to an improved sense of empowerment. Reminding patients that not every day needs to be perfect but to work on a healthier trend can improve outcomes.
How loved ones can offer support
Support from family and friends is also essential in managing diabetes and preventing burnout. Loved ones can help by being patient, understanding and encouraging. Everyone's experience with diabetes is unique and can change over time. Ask questions, learn about the disease, celebrate their wins, know how to respond to emergencies and recognize when to step back.
Find more helpful tips in these posts from the Parkview Dashboard:
This is how parents can impact their child's risk of prediabetes
Managing your child's diabetes at school
Type 1 diabetes: progression, screening and intervention
Simple strategies for making insulin injections easier
Final thoughts
Managing diabetes is an around the clock effort. There will be periods of progress, just as there will be setbacks, but you don't have to do it alone. The Diabetes Care Team at Parkview provides thorough education, support and empowerment for individuals with diabetes, ensuring a strong foundation free from judgment or shame.
If you or a loved one are struggling with burnout or have additional questions about managing diabetes, please call Parkview Diabetes Care Services at 260-373-4280 to speak with a diabetes educator, registered dietitian or lifestyle change specialist.
