Let’s Talk: Diabetes Distress and Burnout

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Understand the impact and signs of diabetes distress

Nobody describes living with diabetes as a walk in the park. It is, however, very common to hear people with diabetes describe the condition as overwhelming, frustrating, and exhausting. 

Diabetes distress is defined as the worries, concerns and fears among individuals with diabetes and their family members as they navigate managing their condition over time.¹ Managing diabetes is hard and demanding, and can lead to a looming sense of burden. Most people living with diabetes experience diabetes distress at some point (or at many points) in their lifetime. Greater experiences of diabetes stigma, or the feelings of blame, shame, or judgment that a person may experience due to their having diabetes, are associated with increased diabetes distress.²

If these feelings lead to disengagement from one’s self-management behaviors, it is known as diabetes burnout. Diabetes distress and burnout are unique from other mental and behavioral health conditions because they relate specifically to living with and managing diabetes. Diabetes distress and burnout can have a negative impact on physical health, mental well-being, social interactions, and diabetes-related behaviors.^1,2 Identifying signs of diabetes distress, using a strengths-based approach to offer support, and connecting people to additional resources are essential components of any diabetes management practice.¹

Choosing stigma-free language

Diabetes stigma can negatively impact care outcomes and make it difficult to have safe and productive conversations about diabetes distress and other aspects of mental and behavioral health.³ How we talk about diabetes distress can transform the conversation. Choose to use language that:

1. is neutral, nonjudgmental, and based on facts, actions, or physiology/biology ^4,5 
2. is strengths-based, respectful, inclusive, and imparts hope ^4,5  
3. is person-centered and focuses on the individual’s needs ^4,5  
4. fosters collaboration between people with diabetes and their healthcare teams ^4,5

Having stigma-free conversations about diabetes distress

1. Have a plan to proactively screen for diabetes distress and explore solutions.¹

2. Explore all factors that may be contributing to someone’s management behaviors and outcomes.

Diabetes management is challenging even on a good day. Oftentimes, diabetes distress or burnout may coincide with other challenges, such as experiencing shame or self-blame, struggling to access tools and treatments, or feeling hopeless about a recent health setback.^2,3 

Express genuine curiosity and concern and take the time to explore what other challenges or barriers someone may be experiencing. Oftentimes, simply asking how someone is doing and what challenges they are facing, listening with genuine curiosity and care, while providing them a few uninterrupted moments to share, can make a big difference. Exploring each person’s unique challenges opens the door to deeper collaborative decision-making and goal-setting based on their strengths. 

Noticing someone’s strengths and successes they have had with diabetes can also help support diabetes management and sense of well-being. Taking the time to recognize the effort a person with diabetes puts into their self-management can go a long way to countering stigma.

3. Normalize experiencing challenges and keep the conversation open.

Diabetes distress can ebb and flow throughout someone’s lifetime, but it is a normal part of the diabetes experience.¹ Oftentimes, people with diabetes have never heard that other people may be experiencing the same feelings they are. They may even feel a sense of shame or judgment from others for not being “good enough” or “having it all together.” If someone opens up about hardships, validate their experiences, ensure they know that nobody is to blame for their diabetes, and reaffirm that feeling overwhelmed is common. 

Even if someone is not experiencing distress now, they may later on. Keep an eye out for signs, such as someone expressing they feel the need to hide their diabetes from others or stop thinking about it, sharing that they can’t keep up with their management, as if nothing they do works, or feeling as though they are becoming more of a burden to others. Signs like these may indicate that it could be helpful to screen for diabetes distress and connect someone to additional support if it is beyond your scope to address all of their concerns.¹ 

This resource was created for dStigmatize, a diaTribe Foundation program, with support from Lilly, AstraZeneca, the Boehringer Ingelheim-Lilly Alliance, and Genentech.

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Citations

1. American Diabetes Association Professional Practice Committee (2025). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025. Diabetes care, 48(Supplement_1), S86–S127.
2. Holmes-Truscott, E., Ventura, A. D., Thuraisingam, S., Pouwer, F., & Speight, J. (2020). Psychosocial Moderators of the Impact of Diabetes Stigma: Results From the Second Diabetes MILES – Australia (MILES-2) Study. Diabetes care, 43(11), 2651–2659. https://doi.org/10.2337/dc19-2447
3. Speight, J., Holmes-Truscott, E., Garza, M., Scibilia, R., Wagner, S., Kato, A., … & Skinner, T. C. (2024). Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. The Lancet Diabetes & Endocrinology, 12(1), 61-82.
4. Dickinson, J. K., Guzman, S. J., Maryniuk, M. D., O’Brian, C. A., Kadohiro, J. K., Jackson, R. A., D’Hondt, N., Montgomery, B., Close, K. L., & Funnell, M. M. (2017). The Use of Language in Diabetes Care and Education. Diabetes care, 40(12), 1790–1799.
5. J, S., T C, S., T, D., T, B., G, K., C, L., R, S., & G, J. (2021). Our language matters: Improving communication with and about people with diabetes. A position statement by Diabetes Australia. Diabetes research and clinical practice, 173, 108655.