'Diabetes burnout': The mental-health impact of diagnosis

Naomi struggled to come to terms with her type 1 diabetes diagnosis

"It's a full-time job that you can't quit. It's a massive burden that you didn't ask for, didn't expect."

Diagnosed with type 1 diabetes at the age of 19, Naomi, now 33, says she reached a point where she simply could not handle "the physical or mental challenges of diabetes any more", a condition known as "diabetes burnout".

About 250,000 people in England have type 1 diabetes, which means the body cannot produce insulin, the hormone that controls blood sugar levels.

It can lead to organ damage, eyesight problems and - in extreme cases - limb amputation.

But for many there is also a significant psychological impact of learning to manage the condition.

Naomi felt she could no longer bear testing her blood sugar levels many times each day to calculate how much insulin she needed to inject, even though she knew she was risking her long-term health and putting herself in extreme danger, at risk of developing diabetic ketoacidosis (DKA), which can lead to a coma.

And she became so ill she was admitted to an eating disorder unit even though she was not struggling to eat.

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The head of the unit, Dr Carla Figueirdo, says of her diabetes patients: "These people are seriously unwell, seriously unwell.

"They are putting themselves at harm every day of their lives if they don't take their insulin.

"They could die."

Naomi's consultant at the Royal Bournemouth Hospital, Dr Helen Partridge, says the psychological impact of a diabetes diagnosis should not be underestimated.

Dr Partridge says the psychological aspect of living with diabetes "is huge"

"You've got to learn to live with it day in, day out," she says.

"It is not going away, unfortunately.

"And so, actually, the psychological aspect is huge."

'Improve outcomes'

The hospital is hosting one of two NHS England pilot projects looking at how to treat type 1 diabetes patients whose chronic illness affects their mental health.

NHS England diabetes lead Prof Partha Kar says: "The NHS long-term plan commits strongly on getting mental and physical health together.

"If we do tackle these two together, it will help improve outcomes."

Naomi, who has now left the unit, says: "I am really grateful that I came here, terrifying as it was.

"It saved my life.

"And I am really grateful for the team here."

'Choose life'

The pilot scheme has helped more than 70 people like Naomi, many of whom, the team say, would have gone undiagnosed without it

And Naomi herself now feels able to look to the future.

"Even if there is not a cure, there is still hope," she says, "Always hope. And we get to choose life every day.

"So it is an opportunity to choose life."