DIABETES BURNOUT

The American Diabetes Association here attempts a more realistic tone in helping with the stresses of long-term management of the disease—but doesn’t even come close to addressing the anguish and uncertainty reported by recent authors with diabetes, and thus can’t really help wrestle with those demons. Psychologist Polonsky adopts the persistently upbeat, encouraging tone that those with the illness have criticized (and that Butterfield’s Showdown With Diabetes and Roney’s Sweet Invisible Body, for instance, so successfully avoided). “Is diabetes driving you crazy?” he asks brightly. “If so, welcome to the club! In fact, a very large club!” Polonsky’s aim here is to overcome the burnout of managing an unending, often volatile disorder on a daily basis, and he does acknowledge at the outset two of the thorniest problems. Not even following medical directions to the letter will prevent —crazy days when blood glucose levels rise or fall dramatically for no apparent reason”; even worse, “there may be scary days when minor—or major—complications suddenly appear.— Polonsky advises self-testing to determine both the degree of burnout and the cause (from taxing self-care to relationships and other stressors), examines each cause in turn, and presents coping mechanisms. There are some helpful suggestions here, but Polonsky’s tone—epitomized in the fable of the “Blood Sugar Fairy” who causes —weird and wacky occurrences” like insulin shock—is as repellent as a night nurse’s whimsical cheer. For the establishment line, Touchette’s The Diabetes Problem Solver is better; for context and consolation, try Butterfield and Roney.