Diabetes Self-Management Articles

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Extinguishing Burnout

by Diana M. Naranjo, PhD, and Korey K. Hood, PhD

• Aspects of diabetes management are slipping through the cracks.

• You feel isolated or have trouble getting the support you need.

• You are experiencing a lot of guilt or feeling blamed.

• You are annoyed that your child’s diabetes management is not perfect.

Management is slipping. Most parents experiencing diabetes burnout begin to notice that the pieces of the routine that normally happen are slowly deteriorating. Perhaps you flip back through your logbooks, whether paper or electronic, and realize you have missed logging a couple of meals or even days — and you cannot come up with any good reason they are missing. Or maybe you start to guess at the number of grams of carbohydrate instead of reading package labels or weighing foods you would normally weigh. This is very much out of the norm for you. Or perhaps you notice a pattern of forgetting to refill prescriptions in advance.

All of these things will happen on occasion, and as isolated events, they are not too worrisome. However, if you start to notice that things like this are becoming common occurrences, it may be time to consider diabetes burnout.

Isolation and lack of support. Another common sign of diabetes burnout that parents can feel is isolation. Does this story from a mother of an 8-year-old with Type 1 diabetes sound familiar? This mother said she felt that she was the only one in the family who was responsible for her daughter’s diabetes. “Everyone takes turns walking the dog. We have a schedule of who does dishes every night. We all have to work or go to school. But I’m the only one waking up three times a night to check if she’s low; I’m the only one looking at what she eats. And when things aren’t going well, I’m the one who gets blamed!”

There are two things of note in her statement. First, she feels alone in taking care of her daughter’s diabetes. When you feel alone and unsupported, you are much more likely to become overwhelmed. As a parent of a child with diabetes, you know that these things have to get done and will, but this mother also knew that she could help her daughter even more if she had some help for herself. We are all better helpers to others when we feel supported, appreciated, and not overwhelmed. Second, she ends by saying that she is also feeling unfairly blamed.

Guilt and blame. Guilt and blame are complex and have many layers as they relate to diabetes care and burnout. As a parent, you may feel tired of managing all the components of care. The mother described earlier started to feel overwhelmed, could not entirely keep up, and then starting feeling guilty that her child’s diabetes outcomes were not as great as she would have liked. She also felt blamed for not doing a better job. It is a vicious cycle.

If you attempt to counter your feelings by telling yourself you shouldn’t complain because your child can never get a break from diabetes either, you may feel even worse. That’s why it’s better to talk about these frustrations, feelings of being overwhelmed, and particularly any guilt you are feeling. Guilt and blame will not help you or your child, so it is critical to find ways to overcome these feelings.

Perfectionism. Something else that fosters the development of diabetes burnout, and consequently serves as a sign that burnout is on the horizon, is when parents have to have perfection. This usually plays out by aiming for blood glucose levels that are always in a very tight range, and constantly searching for the reasons for “bad” blood glucose levels. Don’t get us wrong: We are advocates of intensive diabetes management and help families find ways to carry out the behaviors needed to achieve the safest and healthiest control of diabetes possible. However, aiming for perfection typically leads to frustration, disappointment, and ultimately diabetes burnout.

The problem with aiming for perfection is that so many things go into achieving optimal control, and you can’t control all of them. Diabetes management is not always predictable. The cause for a high blood glucose level today may not be the same cause of the high blood glucose level tomorrow. When you set out to have all perfect blood glucose levels or that perfect A1C level, you can set yourself up for feeling like a failure. Anything that falls short of perfect, even if it is the best you and your family can do at that time, may cause guilt and blame and diabetes burnout.

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