Every minute of every day, a person with diabetes faces decisions, thoughts, worries and fears about their diabetes and the future impact the condition may have on their health. It’s estimated that, on top of normal daily choices, people with diabetes face up to 180 diabetes-related decisions every day. That’s more than 65,000 extra decisions in a year!  

Managing diabetes can feel like a full-time job at times: checking blood glucose levels, taking medications, remembering appointments, thinking about what and how much to eat, and keeping active. It also frustrating. How can you eat the same amount of the same food, at the same time, two days in a row, yet still get completely different glucose results each day? Add to all of this day to day stressors such as work, financial worries, and the challenges of new, yet sometimes imperfect technology, and it’s no surprise people experience burnout.  

Burnout is real 

You can experience distress or burnout at any time. It is normal to feel frustrated and anxious at times about having to manage a chronic condition, but intense or ongoing feelings can be a sign of diabetes distress or burnout. Diabetes distress, anxiety and burnout are very real complications of diabetes. 

Diabetes distress versus diabetes burnout  

Diabetes distress can occur when concerns about managing your diabetes start to impact on your daily life, including your work, school, family or social life. If you are feeling overwhelmed by the demands of diabetes, frustrated that you can’t control your blood glucose readings or feel guilty that you are ‘failing’ when things get a bit off-track, you may be experiencing diabetes distress. 

Diabetes burnout is the term given to the state of disillusion, frustration and perhaps a level of submission. It occurs when your distress intensifies and it feels like managing diabetes is too much to cope with. Often it will be a state of mind that is reached after years of dealing with diabetes.  

Sometimes an event or situation can trigger diabetes burnout. For example: 

• Stress in your family or at work that makes your diabetes seem less important 
• A new diabetes-related health problem that makes you ask: “What’s the use?” 
• Stress about the money and time you give to diabetes  
• Feeling worn out from years of looking after your health

If you experience diabetes burnout you aren’t necessarily depressed. But sometimes diabetes can feel overwhelming and you burn out from all the hard work. 

What does diabetes burnout look like? 

Common signs and symptoms include: 

• Strong negative feelings, for example feeling overwhelmed, angry, or frustrated about diabetes 
• Feeling controlled by diabetes 
• Feeling isolated or alone with diabetes 
• Avoiding some or all diabetes management activities and being unmotivated to change this behaviour 

At times of diabetes burnout, you may participate in negative behaviours such as not checking blood glucose levels at all, stopping medications or only taking them irregularly, and estimating quantities of insulin rather than checking your levels and injecting accurate amounts.  

Unfortunately, the outcome of the above is to potentially increase your risk of diabetes complications, including hypoglycaemia. It is important to look for help and support when you are feeling like this. 

Diabetes burnout is common 

The Australian Centre for Behavioural Research in Diabetes (ACBRD) conducted a study in which people with diabetes were asked about the mental and emotional health challenges that come with living with diabetes. It found that more than a quarter of respondents felt that the mental health challenges of diabetes made it harder to manage. More than one third said they felt burned out by the constant effort needed to manage their condition.  

This same study also found that nearly half (47%) of all people with diabetes in Australia had experienced a mental health challenge because of their diabetes in the past 12 months. 

Although the majority of people worry most about developing diabetes-related complications, nearly a quarter of people with diabetes worry about the constant burden of the daily management. This burden of diabetes seems to weigh more heavily on those with type 1 (35%) than those with type 2 (19%).  

What you can do 

If you are experiencing diabetes distress, anxiety or burnout, it’s important to look after your emotional wellbeing. Here are some things you can try that might help you overcome, or even prevent, feelings of burnout. 

Manage your expectations 

Do you expect a lot from yourself? When you don’t meet your own expectations, it can be frustrating. If you expect perfection, and perfection is not possible, it’s normal to want to give up. Try cutting yourself some slack. Don’t try to do diabetes perfectly. Accept that there will be good days and bad ones, and that there will be things in life that you cannot control.  

Accept your feelings 

Frustration, worry, and discouragement are a part of life, even more so for people with a health condition. Consider what is making it tough for you to manage. Is it stress? Not enough time? A lack of support? This can help you see where to start making changes, such as asking for help with tasks at home. 

Take small steps 

When things get overwhelming, it’s hard to know where to start. Instead of tackling a big task all at once, try breaking it down into small steps that you know you can accomplish. Taking small steps can make achieving big goals seem a lot more manageable. 

Take a break 

Diabetes doesn’t take a vacation, but you can, at least for a little while. Maybe that means a night off from your meal plan, or checking your glucose levels less often for a day or two. Perhaps you could get a continuous glucose monitor for a week or more so you can keep an eye on your levels without having to prick your fingers all the time?  

On the other hand, diabetes tools can be overwhelming. If you have data burnout you might do the opposite: disconnect from your CGM and/or pump and go back to doing fingerpricks and/or injections for a day or two. It will take some planning to switch over to manual, so before you take a break you should ask your doctor or educator to help you plan for it, so you can be safe. Also, let someone close to you know what you’re doing in case there’s a problem. 

Get support 

Feeling like you’re alone in your life with diabetes is a big risk factor for burnout. If you feel that nobody understands what you are going through or if you feel that you are the only person with diabetes that feels this way, life with diabetes can be a lonely place. While feeling supported does not make diabetes go away, it may make it easier to live with. Getting support, encouragement and empathy from others can be a critical part of staying motivated to manage your diabetes.  

It’s often easier to see what’s not working instead of what you’re doing right. Your support person or healthcare team can remind you of the progress you’ve made and help you with new ideas and strategies.  

Connect with others 

Support groups that meet in person or online allow you to talk with people who know what you’re going through. These are the people who know how you’re feeling because, at some point, they have probably felt the same way.  

Often, people in your life will not know what kind of support you need. Communicate clearly what would be most helpful and what you do not want them to do. Your health care team is there for you too. They can remind you of your successes and help you review your goals to make sure that they are realistic. If things aren’t working, your team is the first stop to evaluate your plan and help you make any changes needed. 

In conclusion 

There will always be ups and downs with diabetes and with life in general. Recognising and preparing for challenges will help you steer clear of burnout. Don’t blame yourself if you find it too hard to manage, but improve your wellbeing by being kind to yourself.  

If you like to learn more you will find that the SANE guide to good mental health is a great resource.

This information sheet from the NDSS is also helpful Diabetes distress factsheet.

And remember, you do not have to do this alone. Our healthcare professionals are available to talk to you via the NDSS helpline: 1800 637 700. 

By Carolien Koreneff, a Credentialled Diabetes Educator and Somatic (body-oriented) Psychotherapist.