How to Help a Teen with Diabetes Burnout

Diabetes can be overwhelming, especially for teens.

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally. This story was originally posted on March 3, 2014.

Growing up with type 1 diabetes adds an extra burden of responsibility to an already overwhelmed teen. In many cases, these teens have had to deal with insulin injections, carb counting, and the fear of overnight lows for years. It’s very likely that at some point, they’ll just want to quit. But type 1 diabetes isn’t like Girl Scouts or soccer or any interest a teen might outgrow. Throw into the mix shifting blood glucose numbers and social issues related to being different from peers, and frustration with the situation can lead to something called diabetes burnout.

Anyone with diabetes is subject to burnout—this isn’t a phenomenon unique to being a teenager. But in these cases parents may mistakenly read the situation as a form of rebellion.

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Joslin Communications Internship Opportunities

Come be a part of our team! Joslin Diabetes Center Communications Department is looking for two interns for the fall semester.

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Hunger Scales: Recognizing Hunger as a Tool for Weight Management

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally. This story was originally posted on Feb. 28, 2011.

This guest post is written by Amanda Kirpitch, M.A., R.D., C.D.E., L.D.N.

“Eating in a developed country like the United States becomes a social, business, and family event, an act of pleasure, that goes far beyond the ingestion of necessary nutrients to sustain life.”  Kennedy and Blaylock, Economic Food Choices, and Nutrition

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Amanda Kirpitch, MA, RD, CDE, LDN is a nutrition educator in the Joslin Clinic at Joslin Diabetes Center. She works with individual patients, as well as patients enrolled in the Center’s weight management programs.

Over time, we may to lose our ability to recognize hunger.  This may be a result of the various reasons we eat that have nothing to do with hunger- we eat for pleasure, stress, boredom, or just because the food is there.  Many people struggle with cravings for foods that may trigger a particular memory or just plain taste delicious- these foods tempt us, healthy or not.

In the Joslin Clinic, one of our goals as providers is to help people get back in touch with their bodies and their true need for food.  We do this using hunger scales.

The use of hunger scales does not guarantee one will never overeat again.  In fact, many theories on the use of hunger scales encourage people to push the limit a little – whether that be once per week or once per day to discover what we like to call “wiggle room” (or boundaries).  The goal in assessing hunger is to become more mindful of our meals and snacks in an effort to curb overall excess and control weight.

If a person is hungry, that person will not succeed in weight loss.  He or she may be able to suppress urges of hunger for a short period of time, but ultimately the body’s desire for food will win over the physical willpower one may pursue.

We use hunger scales to help people realign their eating with their body’s cues for what is needed for energy.  If someone is always eating at the level of a 10 (stuffed), then they are likely eating more than what is required by the body and will likely gain weight.

Someone who is restricting and never becoming full throughout the day may find themselves eating in excess when they become excessively hungry at the end of the day.

The goal is to eat fairly often (about every 3-5 hours), having your meals or snacks no longer than 1 hour after you start to become hungry (thus eating at a hunger level of  about 3)  Then you want to eat until to you are somewhere between comfortable and full (between 5 and 7).

The idea is that if you wait until you are very hungry (about 2 or less), you will end up eating food until you hit a 8-10 (stuffed and uncomfortable).  When we are ravenous, we tend to eat more quickly and overeat to satisfy ourselves.  Eating at a slower pace, gives your body more time to register fullness and keep you adequately nourished and not overstuffed.

In our weight management programs, Why WAIT? and YOU-Turn, we have our patients rate hunger at the beginning of each meal and snack to determine if their intake is satisfying and effective for them. It is helpful to see where their eating is working well for them and also where they may be getting off track.

When we take a look at hunger levels and intake together we can make changes and help people be more mindful of their overall consumption.  It takes the focus off dieting and really helps people see their new eating patterns as a full lifestyle change that they can use to manage their health for a long time.

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Resources for Friends and Family: How to Support Your Loved One with Diabetes

One way to support your loved one with diabetes is to learn healthy recipes that you can cook together. Read on to get more tips!

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally. This story was originally posted on Jan. 13, 2014.

Living with diabetes is no easy task, but sometimes the role of family and friends is overlooked. This article is for people living with someone that has diabetes.

Wanting to support someone you love is natural, but it can be difficult to do if they are suffering from a disease that you know nothing about. Diabetes, like many other diseases, is complex. From the terminology to the medication, it can be overwhelming.

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Overcoming an Eating Disorder with Diabetes

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally. This story was originally posted on Jan. 20, 2012.

“Mirror, mirror on the wall…For my eighth grade self, the day this common household wall-hanging echoed back to me an image that more closely resembled a cylinder of Pillsbury crescent rolls about to burst out of their airtight packaging than a twelve-year-old girl desperate for a single morsel of affirmation, was the day it crossed over to the other side. The war between the mirror and me had begun.”

"Eating to Lose: Healing From a Life of Diabulimia," by Maryjeanne Hunt, available now

So begins Maryjeanne Hunt’s memoir of a life lived with both an eating disorder and type 1 diabetes. The book, released this January, is called “Eating to Lose: Healing from a Life of Diabulimia.”

Like many young women, Hunt started to obsess over her body. And like an increasing number of people in America, she also had diabetes—a disease that forced her to take stock of every morsel that entered her mouth, heightening her awareness of every calorie. She quickly developed an eating disorder referred to in the popular press as diabulimia.

This eating disorder affects approximately 30 percent of women at some point in the course of their diabetes. As with many eating disorders, “it’s a true distortion in their perception” of their bodies, said Ann Goebel-Fabbri, Ph.D., a clinical psychologist at Joslin. That misperception is coupled with the misconception that proper doses of insulin will lead to weight gain.

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Emotions & Blood-Sugar Levels: How Diabetes Can Affect Your Mood

John Zrebiec, L.I.C.S.W. is Director of Behavioral and Mental Health services in the Joslin Clinic at Joslin Diabetes Center.  He is also a Lecturer in Psychiatry at the Harvard Medical School.

John Zrebiec, L.I.C.S.W. is Director of Behavioral and Mental Health services in the Joslin Clinic at Joslin Diabetes Center. He is also a Lecturer in Psychiatry at the Harvard Medical School.

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally. This story was originally posted on Feb. 18, 2011.

This guest post is written by by John Zrebiec, L.I.C.S.W., Director of Behavioral Health at Joslin, and Gail Musen, Ph.D., Investigator in the Section on Clinical, Behavioral & Outcomes Research.

Diabetes can affect both your physical and mental health.

A diagnosis of diabetes certainly adds a huge emotional weight, which can often manifest as depression, anxiety or some other emotional issue.   The same goes for the stress of managing diabetes 24/7.

Recently, Joslin researchers discovered a link between high levels of glutamate (a neurotransmitter in the brain that is produced by glucose) to symptoms of depression in people with type 1 diabetes. Continue reading

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Diabetes Empowerment by Living Vertically

Steve Richert is dedicated to proving there's nothing you can't do when you have diabetes

All July, the Joslin Blog is highlighting stories about taking care of yourself emotionally.

This guest post is written by Steve Richert. Steve founded Living Vertical, a multimedia platform to promote a message of diabetes empowerment.

What is possible–with diabetes? This is a question that has plagued me since I was diagnosed in 1999 at age 16 and being told as I lay in the ICU that my life was effectively over as I’d known it. Answering that query in my own way has occupied the last 15 years of my life as I have invested my time learning how to go beyond the limitations of this condition.

My focus has always been climbing. I was fascinated by heights as a child and to me, being up high on a remote rock face represents the ultimate demonstration of control and self-reliance. It is the ultimate rebellion against the limitations we are supposed to accept as chronically ill diabetics. To some this may sound like a denial of reality or a series of risky capers undertaken at the expense of diabetes management. The truth is the exact opposite. Continue reading

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A Barbecue Nutritional Breakdown

Managing a healthy diet for your diabetes is important—but sometimes at parties and family gatherings, it’s fun to just go with the flow. So here’s a slideshow full of the nutrition information for a traditional Fourth of July menu.  You can pick and choose the foods that will best match your meal plan. Enjoy the day!

*Nutritional information may vary depending on brand, preparation and toppings*

Do you need help managing your diet? Learn more about the Joslin Nutrition Programs.

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Protein’s Role in a Weight Management Diet

Dr. Osama Hamdy is the author of The Diabetes Breakthrough and the Director of the Why WAIT program at Joslin.

This post is written by Osama Hamdy, M.D., Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Management at Joslin Diabetes Center, Assistant Professor of Medicine at Harvard Medical School. Dr. Hamdy is also the Director of theWhy WAIT program where he works with people to improve their diabetes management through weight loss.

This post is a continuation of Dr. Hamdy’s previous discussion on the history of the “diabetes diet.”

Medical Nutrition Therapy (MNT) means using nutrition as a potent diabetes management tool.  MNT not only plays a major role in preventing and treating type 2 diabetes but also helps in preventing many diabetes complications.

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Joslin Tips for a Safe and Healthy Ramadan

For Muslims, the holy month of Ramadan is a time of spiritual reflection, increased devotion and worship. This year, it begins on June 28, 2014. Muslims are expected to put more effort into following the teachings of Islam. During this month, observant Muslims are expected to fast between sunrise and sunset. That means no food and water can be taken during that time.

In addition to abstaining from eating and drinking, Muslims also increase restraint, such as abstaining from sexual relations and sinful speech and behavior. The act of fasting is said to redirect the heart away from worldly activities, cleansing the soul by freeing it from harmful impurities.

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