FUDiabetes

Dealing with Diabetic Burnout

I’m 17 years old, and I’ve been Type One Diabetic for more than 16 of those years. I recently started college but am back home quarantining because of COVID. Recently, I have been struggling more and more with my management. I just feel so burnt out, and everything I seem to do doesn’t seem to have a big impact on my blood. I feel like such a horrible diabetic all the time and like I’m constantly failing at taking care of myself, just nothing seems to be working and it’s so frustrating. It does not help that I also struggle with mental health issues and I get so inside my head because nothing is going right with diabetes right now. I also feel like I’m judged a lot since I prefer shots over my Omnipod, which just doesn’t make me feel any better, especially when things just aren’t going right. I also have a Dexcom CGM, but I get really discouraged looking at the numbers now. Any tips on how to deal with burnout, especially just going into college?

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First, let me welcome you @evvyponder to FUD. We are happy to address your questions. Since I am only a parent of T1 I will limit my responses somewhat, since I haven’t really been in your shoes, but my son will be going away to college next year.

  1. Please don’t judge yourself, i.e. “horrible diabetic” this doesn’t help the situation. You might be struggling but you aren’t a horrible anything.

  2. If you prefer shots, great, we have many members that have fantastic control on shots. My son takes a pump break every year and does just fine on shots. In fact we do the break to reinforce the effort it takes to manage yourself when you don’t have a pump or it breaks. Great skill to have.

  3. If nothing is going right with your diabetes control, please start by doing a basal check. Once you dial in the basal, everything gets easier. My son has had to do these quite often during periods of rapid growth when his insulin needs change.

Please if you take one step, figure out your basal. Then many other things can be pretty easily sorted.

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First, welcome to FUD, and second, ditto everything @Chris said.

This sounds like you have a passive relationship with your CGM. Do you just look at the numbers/line and get frustrated because it doesn’t look “normal”? Or do you respond to what you see – dosing small amounts of insulin if you’re trending higher, or eating a small amount of carb if you’re trending lower, etc.? It’s easy sometimes to look at “bad” numbers and automatically judge oneself – “I’m high. I’m not managing this well. I can’t figure it out. I’m stupid.” I still fall into this when the numbers are out of line, even after 50 years of looking after myself.

Who’s judging? And who cares what they think? It’s your life, it’s your diabetes.

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This is silly. The thing about diabetes is people are very attached to their way of doing things, and many will insist that their way is the only way, be it an insulin pump, a certain basal insulin or whatever else. My control is the same or better on shots vs. a pump, and many of the supposed benefits of pumps are overhyped in the age of stable basal insulin analogues and half-unit dosing pens. When things get bad I try to limit what I eat and that helps a lot. Try eating less carbs for a day, less snacking between meals or even just do one meal low/zero carb when you are stable at a good number just to get off the rollercoaster and feel better about things. Also what insulin are you using for meals? Since switching to Fiasp I am able to eat way more carby things without huge spikes. It’s not perfect but it can make a big difference for some people.

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@Scotteric I use Novolog Flex-Pens for my short acting insulin, and Lantus for my long acting.

After years I finally was able to get my mom to understand where I was coming from and she stopped fighting me on going to my pump. She even stands up for me because I get a lot of comments about it from my family and diabetic friends.

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@evvyponder Welcome to FUD!

I can also be my own harshest critic. This group of folks here has helped me by sharing their real life experiences, questions, experiments, their personal wins and losses.

I was diagnosed with T1D 5 years ago at 55. I may have a different perspective but I understand it’s stressful. It took me a while to figure out what treatments I prefer, what worked for me and what didn’t and to ultimately realize that those learnings specifically apply to me and my diabetes.

Some thoughts - advocate for your self, progress at a speed that works for you is your choice (you don’t need to be perfect) and ask questions of all of us here. We get it!

Lisa :sunflower:

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I agree Beacher. Evvyponder you should not care. If what you are feeling is from your Endo, I can understand. My 10 yr old went through that with me and his doctor this summer. He was just tired of the Omnipod. He wanted to stick himself. I did not understand because his BS were so out of whack. I gave him some time and then I had to firmly get him back into the Omnipod idea.

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@evvyponder, Welcome! You’ve come to a great place. There are many people here who do well managing their diabetes and helping others along the way.

I understand where you’re coming from on the judging business. I have used syringes or pens for the 16 years I’ve had T1D (diagnosed at age 28). Currently Novolog and Levmir. Parents, coworkers, etc. often ask or suggest that I need to use a pump since it seems to them to be like an artificial pancreas or something. Also, every diabetic they know uses a pump, generally speaking. They mean well, but they don’t always understand that, 1) I have very good control without a pump and 2). I have objections to using a pump.

I second @Chris’s suggestion to sort out the basal first. Maybe someone can suggest a good resource on this topic?

Are you currently logging all your D related inputs? It is helpful to have a record of your Blood Glucose, insulin, and food, and how your BG reacted to each input. I personally log my food in the “Fat Secret” app, and log diabetes stuff in the “Diabetes:M” app. These help me to see what’s in the food I’m eating, and track the diabetes related items.

Also, do you test your BG manually to calibrate Dexcom, etc? Some here have had Dexcom differ from actual BG values by a large margin.

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Agreeing with all that has been written, and add one additional - can you exercise? I think about blood sugar management having three elements: insulin, diet, exercise. If you can work all three it’s much easier to control your blood sugar. I’m not hearing a lot about exercise yet. Plus it would make you feel better (clinically proven).

@evvyponder, through no fault of your own, you have gotten a raw deal - especially with Covid happening just as you were going to college. It sucks.

e

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I need this as a mantra (and a t-shirt). Simple and yet so eloquent and sadly not everyone gets it. Thanks for the wisdom @Beacher! :slightly_smiling_face:

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On a side note - @elver love your new profile picture!!

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Thanks @Millz!

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I’ve been a T1 for almost twice as long as you but didn’t get this disease until I was almost 30. I can’t imagine having to deal with this through childhood and teenage years. That fact alone tells me that you are not a horrible diabetic. Just a diabetic with challenges like the rest of us.

I sometimes have periods where insulin doesn’t seem to affect my blood sugars like it should. I feel like I’ve got water in my pump on these days. I honestly believe that this happens when I insert my infusion set into a site with poor absorption. And never forget the influence that stress and life style changes can make on our blood sugars.

I did injections for years but have been on pump therapy for the last decade. First the Medtronic and now a Tandem TSlim with a Dexcom G6 and Control IQ Technology. The pump actually automatically increases/decreases your insulin delivery by predicting what your future blood sugar readings will be. It has made a dramatic difference for me.

I prefer my pump over injections but that is a personal choice and you need to make the choice that fits you and your lifestyle. Not what somebody else tells you should do. And don’t ever consider yourself terrible or a failure at diabetes or anything in life. Be proud of the fact that you have made it through 16 years as a T1. Believe me, 99% of non-diabetics have no idea what this disease is and what we have to deal with to live with it. Accept the fact that you will fail sometimes and treat these failures as a challenge to overcome. And above all else, remember that you are not alone in this. There are hundreds of people going through circumstances similar to you on this and other forums.

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I’ve been on the G6 since it was available, and I love it. I am also considering the Omnipod Dash pump.

Rule #1 - Don’t panic.
Don’t obsess with the numbers- watch the trend. If you are going into a class with a reading of 100 and falling slightly, have a roll or two of Smarties. (6mg carbs of dextrose each- same as Glucose tablets but 1/10 the price if you buy in bulk through Amazon).

Rule #2- Don’t panic. Highs are normal. My wife is not diabetic but she did finger-sticks for a day just to see what is a normal person’s response to food. An hour after eating a dinner (80 grams of carbs- I ate the same thing and I count carbs), her BG was 185. Mine was closer to 200 and by the time we went to bed, I was back down to 150. 150 is where I like to be at bedtime because my BG will continue to drop overnight. I usually wake with my BG in the 80-100 range. (Incidentally, without eating ANYTHING in the morning, my BG will go up to 180. 'Splain that…)

Rule# 3- Don’t panic. You are not alone.

What’s wrong with the Omnipod? I am looking forward to the next generation Omnipod which will work with the G6 to make a closed loop system.

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@SteveMann The Omnipod is fine, I’ve just always preferred shots. My blood also does that weird thing where it goes up if you don’t eat (not the dawn effect, it’s just if I don’t eat for a few hours after I wake up I go high). Mom has told me it has something to do with my body beginning to break down the fat in my body. That was actually a really big problem in high school because I never ate breakfast. Diabetes can be so frustrating…

Anyways, pumps work for a lot of people and I’d rather do injections. It makes me more comfortable and I feel like I have more control. I’ve never actually gotten burned out with shots until now. I was on my pump through the worst times in my life when my a1c was horrible and I had zero motivation to fix it because my mental health was so so bad. I feel confined, also it’s one less thing that my extremely clumsy self will hit on couches and doors.

@Beacher I’ve never really wanted to hide my diabetes or anything, I’ve never actually cared what anyone thought. Yes I feel like so get judged but I’m doing a lot more confident in doing what I want with my diabetes and just making the executive decision that I know what I’m doing and I’m going to do what I do. I do want to get in on this shirt idea tho…

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ALSO! I’m doing a lot better this week and working on not judging myself for the numbers. Someone once told me that it’s just data, and that’s helped. I even had almost 70% in range over two days! It’s still an uphill battle but thanks for all the help everyone!

(I also got out of quarantine that really helped.)

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Really glad to hear that you are feeling better, and doing better! Both are good signs.

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Here’s some good reading from the Mayo clinic on the dawn phenomenon. It’s actually very common for all people to experience this. Non Ds natural responses counter the effects but Ds don’t have that ability.

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