Diabetes And Burnout - How I Overcame It and Rediscovered A Joyful Life
Diabetes takes an incredible amount of mental estate. The constant involvement required to decide what to eat, when to eat, whether to eat at all, how much to inject and what to expect in the hours to come can be overwhelming.
I always do my best to stay on top of it, but there are so many factors outside of my control that sometimes I just feel like giving up altogether and stop trying.
In the past, that part of me used to take over, the sense of burnout arising once every couple of months at least.
It took me some courage and determination to sit down with it, dissect it, understand it and solving it. It was not easy, but as anything difficult in life the initial effort has been worth it and to this day, despite several struggles, I am reaping immense benefits.
I am now managing my type 1 diabetes with much more levity, with better results, and without burning myself out in frustration ever so often.
Let me share what has changed in my approach!
Stoic approach
It all originates in Stoicism. This blog article will not become a philosophy seminar (or maybe…), but there are some crucial concepts to know to navigate diabetes and life with some real agency and self-confidence.
This quote from the immense and eternal Marcus Aurelius is all you need to read:
“You have power over your mind - not outside events. Realize this, and you will find strength.”
How reading this changed my approach to diabetes? In short, I evidenced that I had far more agency on the management of my condition than I thought at the beginning, and that I had been living my diabetic life passively accepting some narratives sold to me as “inescapable facts”, which turned out to be absolute crap.
Does any of the following sound familiar?
“Avoid too many carbs, especially fruit, because they’ll cause spikes. Focus on fats and protein instead!”
“Get used to the blood sugar rollercoaster because they’re inevitable for a diabetic.”
“I know I know, the CGM alarm waking you up at 3AM is annoying. But hey, that’s how things are for us.”
Not to mention all the advice to go keto, to fast all the time, to avoid too intense exercise because it drops our blood glucose, or to accept and live with the fear that a hypoglycemia will hit when you’re in the middle of your walk, work meeting, study session, exam.
Believe it or not, all of this was told to me by doctors and peers, and for many years I accepted it without ever questioning it. Once the stress and the frustrations took over and really ruined my everyday experience of life (how fun is it to not be able to enjoy a walk because you know you’ll go to a hypoglycemia?) I decided I had to do something.
So I’d apply the stoic mindset and start to take ownership of all the variables that I knew I had agency on.
Recognize What I Can Control
I’ve recently come across this other quote from Jeff Bezos which really resonates with what I am trying to articulate:
“Stress doesn’t come from hard work. Stress primarily comes from not taking action over something that you can have some control over.”
This also describes in perfect fashion the radical mindset shift I had around two years ago. I was so persuaded by the idea that big blood glucose swings were supposed to be a fact. Every diabetic and doctor I knew pretty much accepted it and evangelized it as “normal”.
I was told I had to live with it, and so I let that narrative ruin my days for years. I could not plan my life, my days, my hours only because I knew that whatever plan or activity would be interrupted by a big hypoglycemia, which I’d have to fix with a ton of white sugar, which would skyrocket my blood glucose to the other end of the spectrum and force me to inject some insulin to bring it down.
That was my frustrating, irritating, nerve-wrecking, I-want-this-to-be-over-but-it-never-will reality for nearly 12 years.
Until I realized those prepackaged narratives were complete nonsense and that I had more than “some” control over this situation. Also, my health became my top one priority, and I committed to do whatever was in my power to preserve it.
What I Have Control Over
The Pillars Of Human Health
Early on, I didn’t have the maturity to take responsibilities: as a teenager I accepted the swings between 400 and 50 if that allowed me to eat pizza while watching Netflix, no problem. “You Only Live Once” I was telling myself!
But when these swings impeded my every day most basic activities like studying, hanging out with my friends, exercising, enjoying a day out, I started to realize that the life I was living was an actual nightmare. And that’s what set me up for the journey that led me to read books, articles, attending seminars and organize all of it into practical tips I could implement in my day to day.
The goal was to live well and do all I wanted to do, in a simple way.
You can download the Seven Questions that have
changed my life and made me a better type-1 diabetic (and person!).
It’s free! 😁
When I have swings and things go out of control, before I blame the universe for how much life sucks I check for the seven pillars of health first.
They work for everyone, diabetic or not, for the mere fact that we have evolved to be human beings (check the links pointing to actual scientists to dive deeper). Scientists with a brain much efficient than mine have illustrated why, from an evolutionary standpoint, these pillars matter (let me know if you want me to dive deeper!), but for the sake of today’s article I have translated the 7 pillars into 7 easy questions:
WATER: Am I drinking enough? Am I hydrated? Drinking diet sodas or coca cola doesn’t count here. Am I drinking enough water? Am I consuming water rich foods such as whole fruits and vegetables?
LIGHT: Am I seeking exposure to natural light? Light (the one illuminating your room doesn’t count) is essential to regulate our circadian rhythm and sleep patterns, which in turn is essential to sleep well, lower inflammation and perceived stress.
AIR: Am I breathing well? Am I stressed? The science of breathing tells us modern humans have forgot how to breathe properly. The way we move (or not move), the frenetic rhythms of our days, our anger. All these compound and turned us from nasal breathers into mouth breathers, with incredible bad consequences on our overall health.
MOVEMENT: Am I moving enough? Humans are designed to move. We have evolved to do so. If we don’t move, our bodies atrophise. “If you don’t use it you lose it” applies well here. And if you don’t move, your blood glucose will do things you don’t like.
FOOD: Am I nourishing my body or simply “eating food”? Am I eating whole foods close to those I’d find in nature, or am I eating 21st century “foods” that have barely any nutritional value and a whole lot of things that harm me like processed fats and carbohydrates (my apologies, delicious pizza…)?
SLEEP: Am I sleeping enough? And well? We can try all the tricks in the arsenal, but without sleep everything is compromised. Everything. Blood glucose regulation included. If you want your blood glucose to be stable, sleep.
NATURE: Am I spending enough time in nature? Nature heals us. It helps us relax. It reduces stress and anxiety levels. Our body comes back to a state of calm, which lowers the inflammatory symptoms that contribute to unneeded increases in cortisol - which contributes to blood glucose spikes. When I feel burned out, a walk in the woods heals me.
Because we as a species have evolved around these pillars, they are rooted in our DNA. Any human being cannot function properly if some or all of these are missing. And of course, the lack of them will impact the stress and inflammation levels in the body that eventually reflect into high blood sugars, insulin resistance, and all the things a diabetic knows way too well.
First I check for these Seven Pillars, all of which I can act upon. Then I proceed.
My Daily Tracking Habits
When I’ve done my homework, checked and hopefully ticked most of these pillars, I turn to my day to day in search for any missing pieces of my diabetes tracking.
As I’ve learned and shared in previous articles, type 1 diabetes is in large part a game of measuring things, tracking them, doing calculations and informing decisions using these calculations.
Without knowing my macronutrients intake, my total insulin, my carb-to-insulin ratio and so on, every injection and every meal turn into a gamble that we are most likely to lose.
So the next step is auditing my diabetes-related habits:
am I logging the food I eat?
am I calculating my boluses right, or am I guestimating and then “rage bolusing” when things get out of control?
am I eating whole plant based foods rich in carbohydrates and nutrients? Is there any overconsumption of fats and proteins that might cause insulin resistance?
Once I’ve made all these checks, ensuring that I am doing everything in my power to get my diabetes management right, only then I allow myself to look outside, blame the universe, consider the exoteric, or simply accept that there are factors that are harder for me to control.
I am a finite human being, that happens!
What I Can’t Control
So I have done everything. I have slept, moved, counted my macros, my insulin doses, done all the calculations, drank, breathed, been outside.
That’s fantastic, except that my blood glucose is still at 350 and doesn’t want to come down.
So what do I do when despite all my best efforts things don’t work? I take a breath, accept the situation and move on.
In the past I used to “rage bolus”, beat my self up and spend hours - if not days - overwhelmed with frustration and anger. That destroyed my mood, made me hate diabetes and ruined my days in such a profound way that often lead to depression.
Until.
Until I understood that there are periods, events, factors that go way beyond me. I can’t control it all. But as long as I am doing my best to cover the basics (see above), which borrowing from the Stoics can be rephrased as “strengthening the inner citadel”, then I will be more resilient to the occasional storms of life.
And when they come, accepting them with ease of mind helps me more comfortably take shelter in my citadel, confident that I’ve done the work I could to strengthen it.
I can’t stress how deep and transformative this mindset shift has been for handling the stress that comes with daily diabetes management. It has helped me gain confidence in myself, improve my actual time in range, my HbA1c, all the biomarkers, and even run marathons without diabetes ever being a hurdle.
It has turned diabetes from an obstacle and an incredible source of stress and burnout into real fuel.
A new and constant source of energy that allows me to achieve what I want to achieve.
A great conversation about the importance of Emotional Health for managing type 1 diabetes!
