Self-managing diabetes can be a challenging process; it is a daily task for the patient and will take a toll on an individual’s morale. A survey conducted by Abbott and Diabetes Singapore found that 39 percent of the Singaporean respondents with Type 2 Diabetes Mellitus experience Diabetes Burnout. To enlighten us on this topic and share more about the implications it would have on a diabetic patient is Ms Anna Jacob, Nutrition Director from Abbott Nutrition International, Singapore.
Diabetes Burnout is a phenomenon that refers to a state of emotional or physical exhaustion which is a result of being frustrated and overwhelmed by the burden of diabetes self-management. Patients with diabetes may feel the lack of motivation to continue performing proper self-case; this could result in worsening of the disease condition and lead to development of diabetic complications.
To provide support for patients in self-management of diabetes, Abbott and Diabetes Singapore teamed up to deliver a series of activities for both the patient and caregiver to understand and handle Diabetes Burnout. Some of such activities include, workshop series, educational materials, and talks during the World Diabetes Day Event 2019 at the Ng Teng Fong General Hospital to raise awareness of Diabetes Burnout.
1. What are the contributing factors to Diabetes Burnout?
Diabetes Burnout refers to a state of emotional or physical exhaustion caused by feeling frustrated and overwhelmed by the burden of diabetes self-management.
To find out if diabetes patients in Singapore experience burnout when it comes to managing their condition including making daily decisions about their food and nutrition, Abbott partnered Diabetes Singapore to identify areas that patients struggle with most, and found that respondents with Diabetes Burnout experience distress across 4 key areas – namely, Emotional Distress (46%), Regimental Distress (39%), Interpersonal distress (34%) and Physician-related Distress (29%).
- Emotional distress refers to an individual’s feeling or
reaction to the self-care demands of diabetes. They may express concern that they will end up with serious long-term complications. For instance, feeling that diabetes takes up too much of their mental and physical energy every day.
- Regimental distress happens when individuals feel that they are not monitoring their blood glucose levels frequently enough or are not succeeding in their diabetes routine. Because of this, they may lack confidence in their day-to-day ability to manage diabetes.
- Interpersonal distress happens when patients with diabetes feel that their friends or family are not supportive enough of their self-care efforts. For instance, they may feel that some friends or family do not understand what they are going through and hence they may miss out on social events.
- Physician-related distress can stem from feeling unassured that their doctor understands their condition well enough. Doctors aim to help patients cope or adjust to life with diabetes but if patients find that the recommended diabetes routine is too challenging, they may end up feeling frustrated during the course, which may result in physician-related distress.
2. How would a diabetic patient know that they have Diabetes Burnout? In what ways can they be diagnosed for the condition?
Diabetes Burnout is a silent condition that may go unnoticed by those with diabetes, but patients and caregivers can look out for potential red flags.
Psychological changes such as stress is the most common sign to watch out for. Some notable examples include feeling frustrated about the demands of managing diabetes, worrying about not taking enough care of their condition but having no motivation to change, avoiding regular check-ups or monitoring their blood glucose levels, and making unhealthy food choices regularly despite having healthy food options available.
3. How will helping the general population understand Diabetes Burnout support better management of diabetes in Singapore?
Diabetes Burnout in individuals with Type 2 Diabetes Mellitus has been shown to result in poor adherence,1 reduced self-care2 and poor glycaemic control.3
In our survey, we found that nearly one in three respondents (28%) who perceive themselves as “managing diabetes very or quite well” also experience Diabetes Burnout. Given that Diabetes Burnout can go unnoticed by patients themselves, self-awareness and support from the general population including family members, friends and healthcare professionals play a pivotal role in helping patients these red flags to better identify and manage various aspects of diabetes care to stay in control of their condition.
Allowing patients to recognize and deal with Diabetes Burnout effectively, it will help with better adherence to the rigors of living with diabetes. When caregivers understand the frustration patients with diabetes go through every day and, empathize, it will help them be more supportive.
4. What do you recommend family members or caregivers of diabetic patients do to play an active role in overcoming or preventing Diabetes Burnout?
To help patients with diabetes overcome or prevent Diabetes Burnout, caregivers and family members can engage in open dialogues with them, which also help to decrease interpersonal distress. It may be challenging to initiate the conversation, but a little concern and encouragement can go a long way in reassuring patients with diabetes that they have a strong support system.
In the survey, it was revealed that ‘Making healthy food choices at every meal and snack’ is the number one cause of stress for all respondents with (69%) or without (49%) Diabetes Burnout. Given that the number one stressor was following a healthy diet, family members can help to alleviate their stress by buying or preparing healthier food choices that are suitable for their diet plan.
For example, when shopping to prepare food for them, we can choose foods that are low in glycaemic index (GI), sodium, saturated fat and those that are higher in whole-grains and even no added sugar options. When eating out with them, we can choose to dine at places that provide higher in whole-grain options, lower in calories options and healthier oil.
Most importantly, we must understand that diabetes management can be challenging, and allow them to take a break from meal planning every now and then. For greater confidence and convenience, diabetes-specific nutritional supplements can provide simple and convenient solutions to help support day-today dietary management. [APBN]
- Gonzalez, J., Shreck, E., Psaros, C., & Safren, S. (2015). Distress and type 2 diabetes-treatment adherence: A mediating role for perceived control. Health Psychology, 34(5), 505-513. doi: 10.1037/hea0000131
- Fisher, L., Mullan, J., Arean, P., Glasgow, R., Hessler, D., & Masharani, U. (2009). Diabetes Distress but Not Clinical Depression or Depressive Symptoms Is Associated With Glycemic Control in Both Cross-Sectional and Longitudinal Analyses. Diabetes Care, 33(1), 23-28. doi: 10.2337/dc09-1238
- Poor control is defined as having HbA1c readings >8%.
About the Interviewee
Ms Anna Jacob, Nutrition Director, Abbott Nutrition International, Singapore