Thursday , November 23 2017
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Dealing with Diabetes Burnout

23-year-old female, type 1 diabetes since 5 years of age. A1C elevated to 8.9% after usually having A1Cs in the 6-7 range. Came to see me at the end of our workday after wearing LibrePro (Blinded CGM) to go over her food/insulin/glucose/activity/etc. patterns. First thing she said to me was that she had a Dexcom but hasn’t worn it because battery in transmitter was out for the past 6 months. She told me she really hasn’t been checking her glucose on a regular basis at all. Since having her Dexcom, she started depending on that, and treating from the readings. She did check twice daily when wearing it to calibrate. She said she knows what to eat, she’s just been burned out diabetes wise and needed a break. She said she is now motivated once again to get back on track.

I did not want to overwhelm her. I did not go over the readings from the LibrePro in depth because if she wasn’t checking her glucose it would be impossible to see how things are balancing out. I did not see any patterns of nocturnal hypoglycemia/hypoglycemia or hyperglycemia that concerned me to change her settings. We discussed making small steps. She was open to that. The first step I recommended was for her to contact the company where she had purchased her Dexcom and supplies and request a new transmitter ASAP. She told me she had a lot of sensors. I asked her to check the expiration dates. If expired, order more of those too. The next morning I heard from her. She had already reached out to the company. She needed new orders. We faxed them right away.

We will meet 3 weeks from her appointment, which will give her time to make sure she gets her transmitter and 2 weeks worth of data. She agreed to check her glucose twice daily even before getting her Dexcom transmitter.

Lessons Learned:

  • There are a lot of diabetes to-dos, especially with type 1 diabetes. Diabetes burnout and diabetes distress is not uncommon.
  • For people who know and just have to take a break, as long as there are no serious highs/lows, sometimes one has to tread lightly, and work back up step by step.
  • CGM is extremely important, especially in people who have type 1 diabetes. Not only does it take the guesswork out of diabetes management, it also making managing diabetes easier for the well-educated patient.

 

Anonymous

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