With the number of diabetics in Singapore steadily increasing, how much do you know about this chronic condition? Did you know that patients could also suffer from diabetes burnout? On #HealthSuites, Claressa speaks to Anna Jacob, Director of Nutrition at Abbott Nutrition International, Singapore about the dangers of Diabetes Burnout.

Claressa Monteiro: Could you start by explaining what is diabetes burnout? 

Anna Jacob: Diabetes burnout speaks to the physical and emotional exhaustion that people with diabetes experience when they have to deal with caring for themselves on a day-to-day basis. When you have to do so many things to stay in control then it does take a toll on your emotions and we want to bring the attention, together with Diabetes Singapore, to the person behind the condition of diabetes - the emotions they experience. And it is especially important to recognise it, not only for the patients but also caregivers, to have empathy for them and help them find the motivation to (break) out of it. 

CM: You recently did a study and found that two in five Singaporean adults experience diabetes burnout. So that’s almost half. 

AJ: We focused on over 160 patients with type 2 diabetes. Type 2 diabetes are patients who develop diabetes a little later in life and are overweight. It’s not because they don’t have an insulin, they just have less than they should. I think we know we are in the midst of the war against diabetes and our government is taking an amazing approach by (promoting) healthy living to prevent diabetes as well as identifying patients, treating them early and helping them manage it better. What we wanted to do with the survey is to just (raise awareness about) patients who are trying to cope with the self-care, the emotions behind it and the frustrations they experience. Once they get frustrated, some of them give up and stop (maintaining) a healthy diet, taking their medications regularly, going for exercises and this will result in poor diabetes control. 

CM: Are there symptoms before someone reaches diabetes burnout? 

AJ: As a patient, you can lookout for red flags. Or, family members could look out for signals such as expressions of frustration or not even caring about the basics like taking their medication regularly. 

CM: Four main areas that contribute to diabetes burnout is emotional distress, regimental distress, physician-related distress and interpersonal distress. I’m going to assume that physician-related distress is about not wanting to see the doctor and they’re not necessarily happy with what the doctor has to say to them. 

AJ: That’s right. Many of them worry weeks before going to see the doctor because that feels like a final exam. Regimental distress is when the routine of watching your diet, taking your medications on time, exercising enough frustrates you. The routine makes you feel trapped so that adds on to stress. 

CM: What do diabetics have to do to have a balanced diet? 

AJ: Diabetes is a carbohydrate intolerant disease so you need to know what you can eat and how much you can eat. There is no perfect diabetic diet but there is a healthy diet that every diabetic have to eat for the rest of their life. You need to have a well-balanced diet, make selections of food that are low in glycemic index, you have to eat less fat, less saturated fat, topping up your diet with more fruits and vegetables. And because patients with diabetes are also at a higher risk of cardiovascular disease, you have to eat less salt. This is why we found from our survey that the top stressor, when it comes to all of the aspects of self-care, was (maintaining) a healthy diet every day. 

CM: Is there enough assistance for them at that point? 

AJ: Many patients have access to dietitians in polyclinics or hospitals. But this is why we need caregivers to help patients in choosing healthier options that are low in glycemic index. (They can) even prepare food together and eat healthily as a family so it relieves some of that food choice stress. 97% of patients who participated in the survey want to be empowered about their diet. We need to allow the patient to vent, to help them feel that they are not alone. Family members, friends, caregivers and even healthcare professionals need to emphatise a lot more and allow the patient to express themselves while identifying the motivation inside them that can help them follow through the regimental expectations. 

CM: What else did the survey results show that might have been surprising? 

AJ: We found out that the younger people are more frustrated about caring for diabetics than older people. It could be because they have busy lifestyles, they don’t have the time to prepare food. We also found that men had more diabetes distress than women, probably because women can care about the details and men don’t - so that’s why convenient choices.

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This interview was broadcasted on MONEY FM 89.3 on 28 November 2019.

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