Dietitians Caitlin and Laura discuss diabetes burnout & being a health professional with diabetes

Because it is national diabetes week, we thought we would take the opportunity to sit down with Laura. Laura is a new graduate dietitian who started working with us at the beginning of the year. She lives with type 1 diabetes so we thought we would gain some insight from her on what it is like to be a health practitioner living with the condition.

What type of diabetes do you have, and at what age were you diagnosed?

When I was 7 years old, I was diagnosed with type 1 diabetes.

Can you tell us the difference between Type 1 & Type 2 diabetes?

Type 1 is an auto-immune disease where your body’s immune cells attack the insulin producing (beta) cells in your pancreas, meaning the pancreas is no longer able to produce insulin. Someone with type 1 diabetes will need to replace this insulin through multiple daily injections or an insulin pump.

Type 2 diabetes is something that happens over time. It is a chronic condition often related to lifestyle choices. The pancreas produces insulin, that allows glucose to move from the blood stream and into the body’s cells where it is needed for fuel. Excess body weight forms a barrier around the body’s cells, meaning insulin cannot access the cells and allow glucose into them as needed.

So the fat is acting as a barrier to insulin moving through?

Yes, exactly.

What are some of the challenges you have faced having diabetes?

I can’t think of one major challenge. I think the main challenge is remaining consistent everyday. I could eat something today, the same as I did yesterday, and my body might react completely differently and affect my blood glucose levels differently. It changes each day depending on so many variables and I think you just have to take it as you go and learn to be resilient. You can have the best control in the world and you are still going to have bad days or moments and that is completely okay.  

Inconsistencies, are they in relation to the amount of activity you have done in a day or have you been able to pinpoint as a professional what causes those inconsistencies?

It might be exercise, sport, stress, hormones, sleep patterns. There are many variables that come into play. You need to know your own body and be able to adapt well to those situations. You get to know your body very well and can handle those situations well.

Did you see a dietitian as a part of your treatment?

I did yes initially. I would have seen one when diagnosed although I was too young to remember (laughs). I have seen a dietitian since. It is important to come back to basics with your diabetes management. Good to touch base with health professionals and see what you can do better.

How do you think people with type 1 can benefit from seeing a dietitian?

There are 3 components that are important in managing diabetes. Your nutrition, physical activity and medication. Nutrition is a huge component. With type 1 diabetes it is important to know how your food and drinks affect your blood glucose levels. Carbohydrate awareness, carbohydrate counting. Food labels, nutrition panels, the spread of meals and snacks across the day.

Have you found that exercise has been a big part of helping you manage your condition as well?

Absolutely. That’s not why I exercise, I happen to have always enjoyed exercise. It has been part of what makes me manage mine so well. It is a constant. Absolutely helps with the management. 

What would you say to someone who is struggling mentally with their diabetes?

I would say that is completely warranted. You quite simply don’t get a break from diabetes. It is not something you can decide to have a few hours break from even, not if you want to be as healthy as you can. When you live with diabetes you face daily thoughts and worries about your diabetes management impacting your future health. Diabetes distress, anxiety and burn out are real complications of living with diabetes. A person with diabetes will face around 200 diabetes related decisions per day – it’s not hard to see why this daily burden can have an impact. It is something that is not talked about as much as it should be. I am glad that it is a focus of this year.

I see a lot of people who are diagnosed who were diagnosed 1 or 2 years ago and putting off seeing a dietitian. It took them a long time to get around to it mentally. When I do see type 1’s as adults they say its throughout their teenage years that they didn’t manage it well or ignored it a little bit more. Would you say you had a similar experience?

Interestingly I think I am quite lucky because I was diagnosed when I was 7 and to be honest, I cannot remember not having it. It has always been second nature to me so I actually feel quite lucky that I didn’t go through the diagnosis stage as a teenager because I can understand why the burn out is a real thing when you can notice the massive change in your life. Like I said I can’t remember not having it, so I feel quite lucky in that way. That burn out wasn’t something I have experienced.

Often with kids, you have your siblings and friends who aren’t necessarily having to do the things that you have to do and think about as well so you can understand why people do get that burn out.

Would you say having diabetes yourself make you a better dietitian or influence the way you practice?

Yes empathising with patients. It makes me think of different questions and ways I can go about that consult because I am thinking of my own experiences and things I would have wanted to know. I definitely enjoy working with type 1s in particular.

I imagine your carb counting skills would be pretty good.

You would hope so (laughs) I do think they are pretty good.

And when people are on different methods like using a pump does that alter the advice that you give?

They will often come having had great education from their diabetes educator and team around that already. Our practice is still around the same nutrition side of things.Do you have any further nutritional advice for young people with diabetes?
Education is key. Nobody else lives with your diabetes 24 hours a day. It is important to learn about your own body and know how certain food, activity, sleep or stress may impact your blood glucose levels. There is so much trial and error with type 1 diabetes and it is important to take a mental note of how your bloods may change throughout the day. You need to constantly ask

Education is key. Initially seeing the right professionals and staying in contact with those people, your dietitian, diabetes educator, endo, psychologist and remaining with them. As well as that getting to know your own body. Nobody else lives with your diabetes 24 hours of the day, everyone is so individual, and you have to know how your body reacts in different situations. You get to know your body very well. You can have all the knowledge behind you, but you need to know how your body works throughout the day. When you can manage it so well yourself, you will find that it does become second nature and your diabetes will not be the focus of your life. That’s the key managing it so well that it is not the main part of your life and you get to do everything as you always have and want to.

So, the more knowledge is power, the more in control of it you are the more freeing it can be.

Definitely, absolutely.

By Dietitians Caitlin Mannion & Laura Irwin

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