Diabetes is an insidious disease. It requires the sufferer to be vigilant about testing their blood sugars, injecting insulin, and keeping track of their diet and exercise habits. It’s no wonder people with diabetes find themselves fatigued and fed up with their illness. Healthcare professionals in the diabetes field have labeled “diabetes burnout” or “diabetes-specific distress” to describe the feelings of hopelessness, frustration, and anguish that are commonly experienced by those living with diabetes. Numerous books, scholarly articles, and blogs have been written about the subject
Diabetes burnout is a reaction to the stresses of living with a chronic illness. For a person with type 1 diabetes, it is not uncommon to do everything “right” and yet still yield unfavorable results. For some individuals, this can lead a person to abandon their diabetes management habits out of frustration and helplessness. Diabetes burnout symptoms vary from person to person; each case of diabetes burnout is individual to the person living with diabetes.
Treatment for diabetes burnout can include seeing a therapist or counselor who has experience working with patients who have chronic illnesses. Some clinicians have found success using Cognitive Behavioral Therapy (CBT) for patients who experience burnout. CBT is useful for teaching patients new skills in order to cope with their illness. It’s also important for someone with diabetes burnout to work closely with their diabetes team to make achievable goals in terms of diabetes care.
On the surface, a person with diabetes and an eating disorder may appear to merely be burnt out from diabetes or that they don’t care about managing their disease. In fact, many endocrinologists have labeled their patients with ED-DMT1 (eating disorder and diabetes mellitus type 1), particularly those who practice insulin manipulation, as noncompliant. Diabetes burnout and ED-DMT1 may sometimes share similar characteristics or symptoms, but they are quite different and require a different treatment approach.
ED-DMT1 is first and foremost an eating disorder, a diagnosable mental illness. Eating disorders are a biologically based illness that are characterized by preoccupation with food, weight, or body shape. Eating disorders often occur co-morbidly with other mental health issues such as obsessive-compulsive disorder (OCD), depression, and anxiety. ED-DMT1 also differs from burnout because ED-DMT1 is a pattern of specific behaviors that persist over a long period of time. The duration of diabetes burnout is generally less and the feelings associated with burnout are less intense than they are for those with ED-DMT1.
Multiple studies suggest that woman with type 1 diabetes are twice as likely to be diagnosed with an eating disorder compared to their non-diabetic peers. Eating disorders require professional help in order to recover. A team approach, including a therapist, endocrinologist, registered dietitian, and diabetes nurse educator, is most successful, particularly if clinicians are knowledgeable about both eating disorders and diabetes.
Doctors should be careful to not chalk up poor diabetes care to mere noncompliance and investigate the patient’s mental health. Diabetes is a difficult, tedious illness to manage, and sometimes seeing a mental health clinician is necessary. Both diabetes burnout and ED-DMT1 are serious and potentially life-threatening. Neglecting diabetes management for any reason may result in serious diabetes complications like retinopathy, neuropathy, or kidney disease. If diabetes is keeping you from enjoying your life or being healthy, seek medical and/or mental health attention.
If you or someone you know has type 1 diabetes and is struggling with an eating disorder,there is help. Visit www.wearediabetes.org for more information on ED-DMT1.
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