After six years of managing the health aspects of diabetes well, I never could deal with the emotional aspects. Every day was like a spelling test I flunked even though I knew the words. This book taught me about accepting 'less than perfect' blood glucose numbers. Now maybe I can relax and stop beating myself up with guilt and worry, something that also makes things worse. This book has wonderful questionaires and evaluations that really help narrow down the reader's needs then offers concrete steps to help overcome whatever aspect is a problem in diabetes care. I will recommend this book to my friends who ask about diatetes.
Thanks.

I read this book, hoping it would be written on an adult level. It is not. It is patronizing and condescending toward those diabetics like myself who have lived with the disease for many years. I was diagnosed 61 years ago and still need help with the stress and anger associated with a difficult life. Yes, I know how to manage my disease. I would not have survived this long had I not had good self-management skills. Yes, I have had both counseling and been put on antidepressants. In spite of what is going well in my life with diabetes, I still scored poorly on every test! Unbelievable, so now I am feeling worse than when I started the book. I think the book is geared for those who need lots of help within a few years of diagnosis. It is of no use for those of us in this for the long haul who need more than the same old solutions and are apparently worse off than we had ever dreamed!

The first think that is important to point out that while Diabetes Burnout is published by the lobbying group the represents the interests of those who PROFIT from Diabetes, not those afflicted, THAT Dr. William H. Polonsky, DOESN'T REPRESENT THE ADA, at all and the book wasn't written for the ADA.

Dr. Polonsky however started a clinic in California to help psychological issues of the grind of maintaining glucose levels as well as trains and lectures doctors from all over the globe to STOP BLAMING THE DIABETIC for the challenges and changes in dealing with Diabetes.

Heck, after reading Diabetes Burnout, it was the first time I ever have had it acknowledged that my feelings that are natural about the challenge of ATTEMPTING to manage my Diabetes are natural and not some sign of weakness.

Understand that the book was published in 1999 (I think), where there are some changes in the understanding of Diabetes and choices.

I agree that the book is not perfect and that a few parts of it seem a little simplistic on working through the psychological issues dealing with the attempt to manage diabetes.

But I would give it 10 stars if I could. It is the first and best book of its kind and Dr Polonsky does GREAT work on this subject. I have spoken to him because, I am immediately be suspicious of anything that comes out of the ADA. Dr Polonsky has never worked for, been paid by or been sponsored by the ADA. The publishing arm of the ADA just saw that they might make some money as publishers of the book.

Just look at the 238 million received by the ADA last year and look at their funding sources. The ADA posts their "Golden Circle", those are entities that have given them over a million dollars in a year. Then look at those in the 500,000 group, etc. As you will see, the funds are from Large Pharm, Insurance companies and Cadbury Schweps (sugar loaded candy and soda). Understand that the money they receive and spend on "research", just goes back to those in their "Golden Circle".

With diabetes, there is no walking away from the difficulties of the illnes; it can't be laid aside when the going gets tough. This great book helps look at and deal with the everyday difficulties that are real parts of living with diabetes. Dr. Polonsky is like a friend who understands and furthermore, has good suggestions for how to handle what you feel you can't live with any more. Great tone, helpful information, comforting message. Great book!

EXCELLENT book for those living with diabetes. Diabetes burnout is very common. This book is full of tips, suggestions, and even tests, to help you in dealing with diabetes.

When I first saw the chapter for "Werewolf Syndrome" I knew I had to buy this book. It makes for an interesting read at first to learn about others' experiences. Though one thing the author fails to do is provide instruction on the process of motivation, and only provides a very shallow surface, if any, of scientific insight into why people get "burned out". I would suggest going to the book store and skimming this book to feel better about yourself but don't take it home with you.

One chapter he could've included would have been MY GENERAL PHYSICIAN HAS MISDIAGNOSED ME! I was burned out on my diabetes type II management. I couldn't get my sugars down! I would go to my GP and get the advice of take these pills and eat right. Then come back in three months we'll see if you're better. After two years I finally went to an endocronologist, *slap-slap*, and he is convinced I am type I LADA diabetes. Sure enough after a couple of insulin shots I am feeling normal! (Well, normal feels like a drug after having hyperglycemia for two years.) This is my chapter for the burnout book, sc$&@ the GP and go to an endocronologist.

When I picked up Diabetes Burnout, I was truly amazed. Dr. Polonsky understands that there are "barriers to self-care," real life problems and situations that get in the way of doing what's best for our bodies.

He knows that people make a cost/benefit analysis when it comes to self-care. If the behavior is too hard or too unpleasant, and the rewards don't seem worth it, we're not going to consistently exercise, check sugars, or eat what we're supposed to.

This problem is not just true for people with diabetes. It applies to anyone with chronic illness, or really, to anybody at all. I knew about this from living with multiple sclerosis, and I wrote about it in my book. But I didn't think anybody else had developed these ideas. I was sure Dr. Polonsky must have some kind of chronic condition himself, because he knows what it's like. But he doesn't have an illness. He's just very insightful.

I really like the humor in this book. I know some reviewers accuse him of being "cutesy" or Disneyfying diabetes, but I think being able to laugh at your situation helps, even when it's really painful. His description of "werewolf eating" and "Diabetes police" are highly evocative -- they get the point across. I don't think he's talking down to anyone -- he has compassion for people's struggles and wants us to feel better.

It's true that Diabetes Burnout does not cite its sources very well and doesn't contain a lot of specific info on diets or other self-care practices. But that's not its purpose. He is giving tools for identifying and overcoming our barriers -- social, practical, psychological or economic. This is important -- some of those barriers may have been with us for decades, and overcoming them can change not just diabetes management, but also entire lives.

He also inspires by telling stories of real people he has worked with, who have made great strides in difficult circumstances. It's entertaining, inspiring and educational (just like my book :-). What more do you want?

David Spero RN, author of The Art of Getting Well: Maximizing Health When You Have a Chronic Illness (Hunter House 2002) and the upcoming Politics of Diabetes: Social Causes, Costs and Cures of an Epidemic (2005). www.davidsperoRN.com

He makes some really stellar points and has already helped me begin changing over to a more "problem solving" approach, rather than my previous approach to type 2 diabetes, which could best be termed "denial and despair".

I think that removing the 'stinger' from long-term diabetes care requires a bit of pseudo-professional detachment. Rather than seeing my diabetes as a great dramatic production, with me as the tragic heroine, his book is helping me to see it as a series of discreet problems needing solutions (where possible) and acceptance (where no solution is possible).

You'd have to know me to know what a drastic change this is from my normal way of being: 'Drama Queen' just doesn't do me justice!

Anyway, I recommend his book to ANYONE with a chronic illness, diabetic or not. In fact, one could just replace the words 'diabetes' with 'obesity' and instantly turn his book into the best thing I have EVER read on the subject of long-term, permanent weight control. His approach speaks to any long-term health struggle even though it is explicitly (and skillfully) directed at diabetes and diabetics.

He makes some really stellar points and has already helped me begin changing over to a more "problem solving" approach, rather than my previous approach to type 2 diabetes, which could best be termed "denial and despair".

I think that removing the 'stinger' from long-term diabetes care requires a bit of pseudo-professional detachment. Rather than seeing my diabetes as a great dramatic production, with me as the tragic heroine, his book is helping me to see it as a series of discreet problems needing solutions (where possible) and acceptance (where no solution is possible).

You'd have to know me to know what a drastic change this is from my normal way of being: 'Drama Queen' just doesn't do me justice!

Anyway, I recommend his book to ANYONE with a chronic illness, diabetic or not. In fact, one could just replace the words 'diabetes' with 'obesity' and instantly turn his book into the best thing I have EVER read on the subject of long-term, permanent weight control. His approach speaks to any long-term health struggle even though it is explicitly (and skillfully) directed at diabetes and diabetics.

I'm a diabetic and have been for 4 years. Living with diabetes later on in my life is living in a nightmare of having the feelings of "I've had enough".......BURNOUT.

On recommendation I bought this book with the thought "another book about facts and figures and how the perfect diabetic should rule his/her life".

On the first pages it goes straight into stories of real people who are going through what I'm going through "thank goodness I'm not the only one". At this point in my nightmare I wasn't looking for strategies on how to deal with this, only to know that diabetics who were in the same situation felt an dealt with it the same as me.

In this book there are sections which have questionnaires to make you really think about how you feel and think about your diabetes. These sections are labelled so you can tell which are relevant to you, so you don't have to read from beginning to end like other books and still feel none the wiser.

I enjoyed the way Polonsky uses humorous names like diabetic police, werewolf syndrome and sugar fairy. At last situations that made me angry and frustrated now make me chuckle to myself and deal with it in a calmer manner.

I would recommend this book to anyone and wish I had read it the beginning of my diabetes which would have helped me like it has helped me now.

WELL DONE DR. POLONSKY !

I love this book, I read most of it in one sitting to get the gist of it and I kept laughing at all the bits that produced either powerful recognition of truth ("Hank felt like smashing his blood glucose meter when he got a high reading") or just pure humour ("Then it should be nice and low...AARGH!!"). Practically everything in it not only sounded familiar but for the first time it was like somebody crystallising lots of feelings and ideas I've had over the years. Even the situations I didn't identify with or that don't trouble me were very interesting, and constructive food for thought. I read the bit about "Diabetes Police" with a certain sour memory of one or two annoying colleagues years ago expecting to find some retrospective analysis, but soon forgot about them because I suddenly realised that my own boyfriend and I have been enacting some of it quite recently. He is very caring, also has helped me a few times through bad times with low blood glucose levels, so now always asks me "Got your glucose?" when we go out or "Are you OK?" almost too habitually...so the result? - yes, a strange desire on my part not to carry glucose. So I read him the part about producing "Diabetes Criminals" and we laughed, discussed it and sorted out some boundaries. I think this book helps you to recognise habitual problems and be objective and pro- active about them. There is so much constructive advice. I particularly like the truthful but non- aggressive style of "well, you have x problem and you have been trying y for years (or even more likely intending to try y) and it doesnt work, so instead of beating yourself up, try a totally different way/ time/ method/ goal etc and lots of examples. I think as well as a good book, it is genuinely useful and practical. I wish (A) I had written this book and (B), I could have had this book 15 years ago, in my difficult years, or even more, could have forced certain doctors to read it! Still I am eternally glad to have lived to see the revolution...

After being a diabetic for 27 years- since the age of 13 months- I have had my days where the idea of measuring another bit of food, getting a shot or testing my blood would send me to the funny farm. I have experenced a great deal of pain in missing family get togethers because I feel too bad after a low blood sugar. I believe this book is for people who have had this illness for some time and do not necessarly need DCCI information but need information on how to face another day.

This book deals well with the topic of diabetics who let their blood sugar run too high because fear, lack of knowledge, frustration.

But this book's views on hypoglycemia in Type I diabetics does not go far enough: The chapter on hypoglycemia reads basically as reassurance that serious 911-emergency-type events, are just "part of the illness" (which is false). The suggestions for treatment and for avoidance of hypoglycemia are medically correct, comprehensive, great. Not only is the assumption false that serious hypoglycemic events are "part of the illness", it is dangerous. Serious hypoglycemic events are avoidable parts of Type I. The book fails to provide fact-based hope that hypoglycemic serious events can be avoided. And yes, those events are avoidable. But the book never even bothers to state that.

There is a new class of Type I diabetics out there: those who read the D.C.C.T. study and understand the need for intensive therapy. The D.C.C.T. study results gives fact-based hope to those wanting to live a long life and avoid the serious, well-known complications of diabetes. And some of that study is well worth emulating by Type I diabetics. However, those who manage their diabetes intensively might then have many more hypoglycemic events. But the book fails to state that those events need to be avoided as vigilantly as having hyperglycemia. Yet the book glosses over the serious events that can occur from continued hypoglycemic events.

The book, for example, neglects to mention that the tight 80 to 120 mg/dl level is considered to be an unreasonable goal since those numbers are just too difficult to reach on a consistant basis. Unless one has a reachable, reasonable goal, one can start to believe that one has to choose between either hypoglycemia or hyperglycemia. 80 mg/dl is far too low for most people trying to manage their diabetes intensively, but the book doesn't mention that. Specialists who study and treat diabetes (endocrinologist, CDE's - Clinical Diabetic Educators) are looking at that 80 to 120 mg/dl range as a range that needs to be adjusted to a range that is safer in terms of avoiding hypoglycemia. The range also needs to be reachable on a consistant basis. A better range that allows the Type I diabetic to avoid the long-term complications of diabetes *AND* the short-term serious complications of continued hypoglycemic events. Many endocrinologists believe that 140, even 150mg/dl is an acceptable level to strive to reach for on a consistant basis. It is also physiologically compatible with the D.C.C.T. results. Yet this information is not even mentioned in the chapter on hypoglycemia.

And I agree with another reviewer on this web site for this book: the book refers to lots of studies, but it doesn't always refer to the specific studies so that one might find and read those studies themselves. The author of the book is a psychologist, not a physician. I found the book helpful to understand totally non-compliant diabetic people. The chapters on understanding the difficulty of daily management, of dealing effectively with "diabetes police" were great.

But knowing those with Type I diabetes who are struggling with intensive management of their diabetes, I was looking for concrete information in which to address their concerns. Some of this book is helpful for that. Finding out how diabetics feel about getting "suggestions" from others, was helpful; becoming a "diabetes policeman" is easy when one cares deeply about someone with diabetes. The book reminds one to address the topic of diabetes with respect, and to understand that the person who has diabetes wants very much to do the best management already.

This book fails to stress the most important part about Type I diabetes management: that intensive management requires a medical "team" approach. That while the patient needs to remain in charge, those with the expertise need to be used often. The resources available to the Type I diabetic are enormous. The advent of the CDE - Clinical Diabetes Educator, has been of huge significance for resolving management issues *especially* for the Type I diabetic managing their diabetes intensively. Yet this fact was not even mentioned by the book. Until CDE's aer promoted actively, the Type I diabetics will not have access to their useful expertise. This new specialization is one that can make the management of Type I diabetes easier, help the diabetic predict and control their lives with greater ease and safer methods.

Author William Polonsky, PhD and the folks of the ADA have yet again slaughtered, (almost unrecognizably) a topic of incredible worth.

Despite the authors appalling assertions, and "rah-rah" disregard... it is not possible to 100% summarily reject this book, (very close but not quite). The author describes the metaphors of the malevolent ~Sugar Fairy~, "werewolves", diabetes "sugar police" to name a few, all amusing analogies, and potent images. All creatures, people whom diabetics meet on an almost daily basis, both in others and themselves. But too little time is spent evolving them, honing them into more meaningful useful images! He gave them a name, NOW what?

Multiple studies, research is described throughout the book, time and again it's quoted, yet NONE is cited/listed anywhere to enable the reader to do further research, much less read those studies in full.

The book is well intentioned, and marks the beginning of ~new gates~ through which others will build the cobbled inroads toward the ~mental health~ management of this disease. An area dangerously overlooked in the medical community.

Yet, as written, what could have been a fabulous masonry gate, (worthy of Roman Architecture), in its place stands a few stones piled together of far less inherent value. The authors credibility quickly is non-existent, (and totally delusional) based on his appalling sentiments, "Checking blood glucose sometimes hurts" (SOMETIMES : O) is the heading which I read, slack-jawed and instantly numb with disbelief.

The author begins the paragraph touting the incredible improvements of technology. Correctly so in the case of the new ultra-fine lancets of today, yet a total mystery (fabrication?) when he mumbles about something called a laser lancet. However, it is the lines 5-6 of this heading which seals this readers opinion:

"If you are checking correctly, it should be relatively painless most of the time." (p102 Sub-Heading 7, lines 5-6).

Refering to blood tests by this statement it is BLATENTLY apparent that despite his "academic credentials", his "Joslin experience" with diabetics, the author is OBLIVIOUS in his ivory tower!

The author this reader suggests might do well to test himself IMMEDIATELY and with far, far more frequency as then a mere few pages later (p105-6) the author advocates "...having a serious talk with your blood glucose meter...." : O. On second thought never mind testing, somebody get this guy some juice, he's hypo!

But the experience of testing even once would meaningfully teach him the arrogance of his false words! The book has very little merit for type 1 diabetics, (or persons with any diabetes experience) and is appalling in it's a-typical ~rah-rah~ cheer leading. And it is tragic because it is a topic that is profoundly needed to be done well...

All in all save the money unless you find it second hand.

William Polonsky, thank you for given us this gift! I am a mother of two diabetic children plus I am a psychotherapist mainly for adolescents with diabetics and right now I am finishing my six month diploma as an educator in diabetics. In this course I have recommended this book highly, since it has given me so many insights about how to deal with the daily anguish, the so frecuent 'I can't take it any more'. As a mother, as a therapist, even though I work from the psychoanalytical point of view, it has been a very helpful book. I think it is a must for every educator in diabetes, I have shown this book to the board of the faculty of medicine and the Mexican Association of Diabetes, they have been very thankfull for the suggestion and are considering making this book part of the course.