Diabetes Burnout...But Not Because of Diabetes

Mental and Emotional Wellness
1

I think it has been well-established that I'm a patient of many different fields. I have some odd form of blood sugar issue that I've termed diabetes and my endo still likes to call "impaired glucose tolerance," which we all know is the same thing. I have so many allergies, some of which are severe, that I think my entire med school class of nearly 200 knows who I am. I have a rheumatologic issue that's currently undiagnosed but which my rheum insists is either fibromyalgia or undifferentiated connective tissue disorder, both of which are diagnoses of exclusion. I also have some other smaller issues, like sinus tachycardia and migraines. In other words, I'm a mess.

I'm usually excellent about diabetes management. I eat well, I test between 5 and 10 times per day, depending on what I'm eating and what trends I've been seeing, I take my meds. I exercise. My A1c's are awesome, though that's probably because I insisted on meds so early.

But for the last month and a half, I couldn't care less about diabetes. I had a rheumatologist appt, and then I had some other stuff happen within that area, and then I fell apart. I'm so tired of being the patient, and I'm so tired of managing multiple chronic conditions that don't get along with each-other, and I'm so tired of not feeling well and being different...and my diabetes management suffered. I think I tested this morning...and that is probably the only morning I've tested this week or last. If I've tested at all it's once or twice a day, and that's just random throughout the day and has nothing to do with when I'm eating or not. I haven't been eating terribly...but I haven't been eating well, either. I have no idea what my BG's have looked like in the last month and a half. I'm not even sure if I've been high during that time, because the highest BG I saw was 138. (I have very bad post-meal responses but otherwise normal glucose, which is why that 138 means exactly nothing.)

I just started exercising again this week for the first time in more than three months--at first because of an injury, but then because I hate exercise and just didn't want to. And even now, I'm exercising more for the rheumatologic issues than for diabetes.

I've had burnout before, usually because my BG is crap and even then only after it improves. It's never lasted for so long, and it's never been this "I can't care anymore" feeling, more of an "I need a break."

I'm not really sure what to do. I'm also seeing a new endo at the beginning of March, and I don't really know what to tell her. (I'm keeping my old one that I love so much, just consulting with this new one because she's a leader in the field and one of my teachers really pushed me to meet her.) I don't want to see another doctor, and I don't want to be the patient again. I'm usually very open with my doctors and am willing to tell them everything and smile and nod when they freak out that I'm so young and dealing with so much, but I don't think I'll be able to do that with her. I just don't want to deal with any of this anymore. I'm so tired of dealing with other health issues that the only one that really takes time and consideration, as well as the only one that can do any real damage (short of anaphylaxis), is suffering.

Has anyone ever had diabetes burnout that wasn't caused by diabetes? How do you get yourself out of the burnout phase and into a place where you can be productive again?

2

Can I ask you this? If you are on a fixed medication dose, meaning you have no way to correct your blood sugar whatsoever, why are you testing 5-10 times a day? Are you willing to consider that possibly this burnout is partly of your own making and that maybe you could relax quite a bit and just take the medication and shift your focus elsewhere? It sounds like you have an awful lot on your plate with school-- and that you’re letting “impaired glucose tolerance” have a much bigger role in your life than it deseves.

3

You and I are very similar in the amount and type of health "stuff" we deal with. I go through this kind of burnout on a regular basis. I've found that, for the most part, I can't do much to speed through it - I just need to let things settle down again and then get back on track. I do think cutting oneself some slack sometimes is important. We can't all be perfect with everything all the time. You're in a super intensive program and you're dealing with a lot of health issues - some of which are probably worse because of stress (stress is one of my major triggers of SVT/tachycardia). As long as your diabetes is not causing major problems or wildly out of control, I wouldn't worry too much. A few months of looser control isn't going to have a far-reacing impact in the grand scheme of things. I'm betting once your schedule and stress settles down a bit, so too might your burnout.

4

Take the break!!!

Take yourself off the hook, and let yourself go for a couple days deliberately. The burned parts are mental ones, and what you need is relief from the flames, for a time.

In the diabetes arena its called a "diabetes vacation", which has some more technical pieces to it. But the idea is the same. You get time off, because you've busted your butt, and for a short time need some sun, a pretty place to rest, and a "friendly" playmate or two.

See what you can come up with... to help you relax.

5

How you feel is how you feel.

It might help to take a breather and come back to it later. I've been trying to figure out how to add a second basal rate for 3 months, or 22 years, depending on how you look at it. Just had a break through yesterday. My data stabilized somewhat and I can see where to go from here. Finding a basal that I can work with has been an arduous journey, but in the end, the solution was quite simple - break one basal rate into two. Sometimes we get so deep into problems that we can't see the simple solutions.

But, you don't always have to be making progress. Sometimes we make progress and sometimes we don't. You don't sound like a mess, you sound like you are working very hard, which is very admirable. Eventually, you'll feel reinvigorated and doors will start to open up. With difficult problem solving, sometimes the best thing we can do is try to NOT solve it for a while. It lets you come back to it, later, with new, fresh perspective that can really help.

6

((Hugs)) I'm sorry. You have a lot on your plate. I go through phases of burnout. I have had multiple health issues and sometimes it becomes so exhausting. I try to accept that maybe I don't do everything I should and as long as it isn't dangerous I let it go. I'll stay that way until I'm feeling ready to tackle things again. It usually starts with a little bit of attention to things, such as taking a walk regularly or other small improvement. Eventually, I get myself back to taking care of things but I try not to kick myself regardless. That only seems to make it worse.