Diabetes Burnout: Symptoms, Prevention, and Treatment (2023)
Time to read 11 min
Time to read 11 min
Monitoring and controlling a chronic condition like diabetes can be a lonely, demanding road. Diabetes care requires constant vigilance and management, from measuring blood sugar several times a day to adjusting medication, diet, and exercise requirements.
Frustration while managing diabetes is a clear indication that it's leading to mental health struggles. If you, or a loved one, are noticing symptoms of diabetes-related distress, here's how to recognize, prevent, and manage diabetes burnout.
Diabetes burnout refers to mental, physical, and emotional exhaustion that arises as a result of constant diabetes self-management.
People living with diabetes may feel overwhelmed by the daily tasks of managing diabetes, like measuring blood glucose levels, counting carbs, or taking medication. This can cause them to experience feelings of frustration, anger, or inability to cope with the condition.
Those who experience diabetes burnout may end up abandoning their diabetes care regimens for prolonged periods, which puts them at a greater risk of complications.
People with diabetes burnout may experience some of the following symptoms:
Stress when it comes to diabetes management.
Disproportionate fear of unwanted results when measuring blood sugar or A1C tests.
Depressive symptoms like feeling powerless and detached.
Avoiding social support from family or friends.
Not being transparent with the health care team about personal struggles.
Lack of energy to continue healthy habits like monitoring food intake or exercising.
Avoiding measuring blood sugar levels as frequently.
Skipping insulin injections or oral medication.
Managing diabetes day in and day out isn't a walk in the park. Compounding stress from daily tasks can cause feelings of being overwhelmed and angry at the disease and the concept of self-management.
The reality of living with diabetes is constantly juggling responsibilities. These include work, chores, childcare, monitoring blood sugar, self-administering drugs, and making healthy choices.
Being unable to meet the demands of any aspect can cause diabetes distress, which is the leading cause of diabetes burnout.
Having a healthy concern for test results is a positive thing when managing diabetes or any chronic health condition. However, once a person becomes burned out, tests become a source of dread.
This could happen as a result of not reaching expectations for A1C tests several times in a row. It could also be due to the condition not improving, although you're giving it proper care and monitoring.
Feelings of powerlessness and inability to cope with diabetes could be mistaken by some healthcare providers as markers for depression.
That said, the major difference between diabetes burnout and mental disorders like depression is that a person with diabetes burnout can still experience joy in other areas of their life.
The symptoms of burnout are linked solely to diabetes care and management, unlike being depressed, which bleeds into other life aspects, as well.
Among people living with diabetes burnout, there's a tendency to withdraw from support systems and feel inclined to control the condition alone.
This usually happens due to the fear of being judged by others, in the diabetes community and outside of it, for unideal coping strategies.
Social withdrawal, unfortunately, adds feelings of shame and emotional distress to the mix and can lead to even more fear and isolation when dealing with diabetes.
An alarming symptom of diabetes burnout is hiding important information from the healthcare team responsible for monitoring the condition.
This can venture into lying about management, food intake, exercise, and other challenges the person might be facing.
Not being upfront with healthcare professionals creates even more challenges for them while managing the condition.
That's because conflicting information and the lack of consistency can send the wrong messages about prescribed care regimens.
Maintaining a healthy weight by eating a balanced diet and exercising frequently is a proven method to manage diabetes and prevent complications.
However, it's also a major cause of diabetes distress and burnout since the effort is continuous and, in some cases, with little reward.
Failing to meet a weight goal can lead to being tired and unmotivated to keep exercising and making healthy food choices.
A routine part of living with diabetes is taking blood sugar readings daily, and sometimes several times a day. This allows the person to monitor their blood sugar and adjust their insulin intake accordingly.
The process is demanding and can get painful, which is why many people who experience diabetes burnout end up abandoning regular blood sugar readings.
Skipping insulin shots or oral drugs for diabetes management is one of the most dangerous outcomes of diabetes burnout. These drugs are essential for maintaining a healthy metabolism without too many fluctuations in glucose levels.
Failure to follow the required drug regimen can lead to sustained high blood sugar levels (hyperglycemia). This can increase the risk of complications like neuropathy, retinopathy, nephropathy, and mental disorders.
Reaching a breaking point when it comes to diabetes management doesn't happen overnight. Although some people with diabetes face emotional distress right after being diagnosed, the majority of people who experience diabetes burnout do so after a few years.
The first step to preventing diabetes burnout is to have a better understanding of its precursor, diabetes distress.
Diabetes distress is a similar condition to diabetes burnout. The two concepts are characterized by negative emotions associated with living with diabetes and managing the condition.
Research suggests that about 25% of people with type 1 diabetes, 20% of insulin-dependent type 2 diabetes, and 17% of medication-treated type 2 diabetes experience diabetes distress.
Anger, frustration, guilt, denial, and depression are all feelings associated with diabetes distress. Being tired and overwhelmed by the idea that this is a lifelong condition may also be a culprit.
It's worth noting that prolonged exposure to diabetes distress at high levels can cause diabetes burnout, and when left untreated, clinical depression may ensue.
Spotting the earliest signs of diabetes distress in yourself or a loved one means you have a better chance of preventing it.
Here are a few signs to look out for:
Feeling frustrated with the daily care regimen for diabetes.
Eating unhealthy food regularly.
Forgetting to take blood sugar measurements as frequently.
Skipping appointments with the healthcare team.
Being in denial about the severity of the condition.
Scientists and clinicians who research the effects of diabetes burnout are convinced that prevention is the best method of dealing with the condition.
This can better help the healthcare team understand the emotional and physical condition of the person living with diabetes and prevent burnout before it sets in.
For the individual person, there are many helpful steps to take to lessen the effects of diabetes distress and subsequent burnout on your psyche. You can try to:
Feeling a certain way about your health and personal well-being can be a lonely, isolating experience.
Part of the common culture is to bury these feelings and not deal with them by putting on a brave face and denying their existence.
However, accepting your emotions and potential grief, frustration, or fear of the future can better help you process them.
This doesn't mean you should wallow in the negative emotions and let them control your life, but acknowledge them and allow them to pass through without suppression.
Support groups are an invaluable asset for anyone dealing with a chronic disease. Not only do they provide you with helpful tools to manage diabetes, but they also allow you to be vulnerable around people who understand your condition.
If you don't have local support groups for dealing with diabetes burnout, you can find countless diabetes online communities. These forums allow you to talk, process your emotions, and get help from people in the diabetes community who share your experience.
The Diabetes Educator describes this form of community as peer-to-peer support. The health advice you receive can be encouraging and even life-changing.
Many online communities are also supervised by healthcare professionals who can guide you as you manage your condition.
Following a routine can be a helpful way to keep your life in order while managing diabetes and other health conditions. However, having all your days look and feel the same can be difficult, especially if you live alone or have a monotonous job.
Taking small steps to switch things up can help you cope with feeling suffocated or overwhelmed. Trying new recipes and new exercise routines and taking a break from rigorous diabetes management can all be beneficial to your mental health.
You can also find new ways of preventing diabetes distress and burnout by adopting new skills and hobbies that might pique your interest.
Gardening, cycling, or any other activity that gets you outdoors is a nice way of combatting boredom and monotony.
The hobbies don't have to be physically demanding; journaling, scrapbooking, knitting, and painting can all be a healthy outlet for your emotions and creative energy.
Your healthcare team's job is to ensure your regimen provides you with the best care possible. They don't just care about charts, numbers, and glucose levels; their main objective is for you to be at your best.
Communicating negative feelings or physical symptoms to your primary care physician, dietician, and therapist can help you catch diabetes burnout.
Remember that your team can only give you the proper support and help you need if you tell them there's something wrong. Asking for the help of qualified individuals can spot any physical or mental health concern before it becomes harder to navigate.
Although diabetes burnout is prevalent, many people outside the diabetes circles have never heard of the condition. This can lead to a well-meaning person saying or doing something that compounds your negative feelings and leads to a spiral of diabetes distress.
Talk about your condition with family and friends. Offer them your insights about how complex diabetes management is and how it requires constant vigilance.
Any person who cares about a loved one living with diabetes would listen, understand, and offer support.
While there's no magic wand to wave and get rid of diabetes burnout, you can still alleviate the symptoms by taking the following steps:
Having an objective outlook on a personal journey like diabetes can feel challenging and even impossible. Every test result and weight goal that doesn't turn out as planned becomes a negative feeling that gets harder to let go of as time passes.
A healthy way to look at it comes from managing your expectations about your body's response to diet, exercise, and medication. Some days are going to be better than others. Sometimes your body will be less responsive to treatment and healthy habits, and that's okay.
Like a chronic disease, any life-long journey has its ups and downs. Your acceptance of this can prevent emotional exhaustion that might worsen your burnout.
Unfortunately, one of the common misconceptions when it comes to managing a chronic disease is ascribing moral judgments to diabetes outcomes. Instead of glucose levels being low, they're "good", and instead of you struggling with diabetes care, you're a "bad" diabetic.
This kind of discourse doesn't help anyone, especially the person trying their best and not seeing the results they want.
Try to monitor the way you use language to describe your condition. If you find yourself constantly using negative descriptors, take a moment to correct course.
A short diabetes break where your main concern is your mental health and wellness can do wonders to make diabetes management less of a challenge.
Allowing a day or two every month where you're not as religious about counting carbs or exercising can give your body and mind a chance to rest. It can also give you the feeling of control when managing diabetes.
That said, you shouldn't completely abandon measuring your blood sugar as it's vital to help you monitor your condition and avoid hypo or hyperglycemia.
Habits like cigarette smoking, excessive drinking, and recreational substance use can sometimes feel like escapism. Unfortunately, they also harm the health of a person living with diabetes trying to manage the condition.
Cigarette smoking has a well-established link with increasing the risk of type 2 diabetes. Also, a systematic review proved a link between smoking and cardiovascular events for people with diabetes who smoke.
As for alcohol consumption, it poses a grave risk of developing hypoglycemia if ingested while fasting. A good middle ground would be to only drink when you've eaten something and not overdo it.
Lastly, recreational drugs can be hard to watch as they vary in their effects on your nervous system in ways that aren't clinically studied. Some of them also mimic depression and can worsen your feelings of guilt and shame, which is counterproductive if you're feeling burned out.
If you find yourself battling emotions like powerlessness, detachment, and loss of control regarding your condition, it's wise to seek help. A mental healthcare professional can guide you through these feelings and help determine if it's diabetes burnout or depression.
Reaching out to peer support groups in the form of online communities or in-person meetings can also pull you out of feeling apathetic toward your health and well-being.
If you're living with insulin-dependent type 2 or type 1 diabetes, fear needles, and dread the daily chore of self-injection, discuss alternative options with your physician and insurance.
New technologies like the needle-free insulin jet injector can alleviate some of your worries and allow you to use less insulin. That's because the injection mechanism allows the insulin to spread through a large area of the outer layer of your skin.
Understanding the risk factors of diabetes distress and burnout can help you spot the first signs of this condition.
If you, a family member, or a friend are struggling with diabetes burnout, reach out to get help from a professional who can help you navigate these feelings.