Diabetes Exhaustion: Characteristics, Manifestations, and Comparison with Diabetes Anxiety
Managing diabetes is a lifelong challenge, and it can sometimes take a toll on individuals. Three conditions - diabetes burnout, diabetes distress, and depression - are emotional challenges that can impact diabetes management.
Diabetes Burnout
Diabetes burnout is a state of emotional and mental exhaustion due to the demands of living with and managing diabetes. It is characterized by feelings of being overwhelmed, exhausted, and unable to maintain diabetes self-care tasks, such as glucose monitoring, insulin administration, and carb counting. Signs of diabetes burnout may include missing or skipping medication, not monitoring glucose levels as frequently, and ignoring or trying to forget about diabetes.
Diabetes Distress
Diabetes distress reflects the emotional burden and worries specific to living with diabetes, such as frustration with glucose variability and fear of complications. It may not reach the clinical severity of pathology but causes significant psychological strain resembling “burnout” in patients with type 2 diabetes.
Depression
Depression is a clinically diagnosable mood disorder involving persistent sadness, hopelessness, and loss of interest in activities. It is always considered pathological and can co-occur with diabetes distress or burnout.
All three conditions can negatively impact glycemic control by interfering with diabetes self-care behaviors. Diabetes distress and depression are linked to poorer self-care and higher Hemoglobin A1c (HbA1c) levels because they affect motivation and problem-solving abilities. Burnout often leads to neglect of management tasks, which may raise A1C by inconsistent glucose monitoring and insulin use.
Research shows correlations between diabetes-related psychological issues and elevated A1C, with approximately 74% of young people with type 1 diabetes exceeding recommended HbA1c levels amid distress and depressive symptoms.
Preventive Measures
Addressing these psychological aspects through support, counseling, and integrated care is critical for better diabetes outcomes. A person should work with their healthcare team to create attainable treatment and management goals. Reducing stress levels through meditation, getting plenty of sleep, and avoiding or limiting alcohol, tobacco, and substance use can help prevent diabetes burnout.
The healthcare team (primary doctor, consultant, optometrist, or nurse) can provide help and new strategies in managing diabetes for a person experiencing diabetes burnout. A person can take a break from their diabetes management routine safely by discussing it with their healthcare team (diabetes vacation).
Advances in diabetes technology (continuous glucose monitoring, insulin pumps, closed-loop systems) may help make diabetes management easier. Higher levels of social support may help lower emotional distress in people living with diabetes.
Instead of referring to glucose levels as good or bad, a person can describe them as high or low to avoid negative language. Letting a person share concerns without being judgmental, asking what they need in terms of support, acknowledging and validating their feelings, being empathetic, and celebrating wins are ways to support someone with diabetes burnout.
It's important to remember that diabetes burnout, distress, and depression are distinct conditions, although they share some similarities such as feelings of powerlessness and being overwhelmed. Diabetes burnout differs from depression, as depression is a general mental health condition that can impair daily functioning.
In summary, addressing the emotional challenges associated with diabetes management is crucial for maintaining good diabetes control. By working closely with healthcare teams, setting achievable goals, reducing stress, and utilizing new technology, individuals can better manage their diabetes and avoid reaching a state of burnout.
Diabetes burnout, diabetes distress, and depression are three medical-conditions that can co-occur in individuals managing chronic diseases like type-2-diabetes. They can negatively impact health-and-wellness by interfering with diabetes self-care behaviors, leading to poorer self-care and higher Hemoglobin A1c (HbA1c) levels. Addressing mental-health aspects through support, counseling, and integrated care is essential for better diabetes outcomes. It's important to remember that these conditions, although sharing some similarities, are distinct: while diabetes burnout is a state of exhaustion due to the demands of managing diabetes, depression is a clinically diagnosable mood disorder involving persistent sadness, hopelessness, and loss of interest in activities.
