November 09, 2022

Feeling the diabetes burnout? You’re not alone.

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Michl Ava 400x300Most college freshman have a full plate of concerns, from finding their new classes to learning how to navigate complex roommate relationships, to adjusting to being away from home. Freshman year can be overwhelming for many.

Ava Michl was traversing her new collegiate world through freshman year at the University of Alabama at Birmingham when she was rocked by an unexpected Type 1 diabetes diagnosis. Up to that point in her life, Michl had no idea she had diabetes.

“I spent three days at Children’s Hospital of Alabama. It was an odd experience– I could literally see my dorm room’s window from my hospital room’s window, and while I felt sick, I was not nearly as sick as most people are when first diagnosed,” said Michl.

Michl notes that during those three days, healthcare professionals got her blood sugar under control and educated her on how to manage insulin therapy. Once released from the hospital, she returned right back to the thick of the college semester with one more concern to manage. But, Michl says she felt lucky to be in the situation she was in.

“I would never say that getting a type one diabetes diagnosis was easy for me, but I do feel compelled to express that I came at Type 1 diabetes from a place of privilege: Birmingham, Alabama is a hub for world class healthcare, I had health insurance, and I also had a strong science background that allowed me to quickly understand what I needed to do to manage this disease,” said Michl.

What many others’ bodies do naturally without having to think about– regulating blood sugar– Michl was now on the hook for managing for herself. For her, it feels like a balancing act that requires a lot of attention each day: it is not something that can be ignored. And, the disease carries with it a large financial burden as well.

According to the American Diabetes Association (ADA), people with diagnosed diabetes incur average additional medical costs of over $9,000 a year. The ADA notes that on average, people with diagnosed diabetes have medical expenditures approximately 2.3 times higher than if they did not have diabetes. This is due to the cost of insulin and other management tools, like pump supplies, glucose monitoring supplies, and additional doctors’ appointments.

Perfect blood sugar management is not necessary, according to the CDC, and in fact, it may not even be possible. Focusing on having no slip ups or out of character spikes could lead to diabetes management fatigue or burnout– feeling unmotivated to address the disease, let alone manage it through testing, insulin, or other prescriptions.

“Diabetes is tough. It takes a lot out of you, and not everyone is going to understand what you’re going through. Your motivation to constantly attend to your blood sugar will ebb and flow,” said Michl. “Burnout is to be expected, so make a plan before it happens.”

To combat her diabetes burnout, Michl joined the College Diabetes Network as an undergraduate and found that it was a lot easier to manage her diabetes when she had support from other people in a similar life phase.

Michl not only conquered her freshman year at UAB, but she ended up graduating in 2020 with a bachelor’s degree in neuroscience.

Now, Michl is a full-time diabetes researcher in the UAB Comprehensive Diabetes Center. In fact, she is a researcher III in the lab of Sushant Bhatnagar, Ph.D., associate professor in the Division of Endocrinology, Diabetes, and Metabolism.

Though happy to talk openly about her disease, Michl’s identity is much more than her diagnosis. In fact, Michl is on track to become a biomedical sciences Ph.D. student on the genetics and genomics track at UAB.

“I am in the process of applying to the PhD program in biomedical sciences at UAB. I am also a student in the MBA program at UAB. I enjoy spending time with my fiancée who is an honors English teacher at Thompson High School, playing video games, listening to my favorite band (Gang of Youths), and reading,” said Michl.

To Michl, Diabetes Awareness Month, which is November, is about learning more about diabetes and how to interact with those affected by diabetes. She feels like understanding the types of diabetes and de-stigmatizing it is key to moving toward curative treatment as a society.

“I understand and even encourage people’s curiosity about diabetes. However, my hope is for people to approach their curiosity in a way that is respectful to everyone involved,” said Michl.

“For instance, if you see someone with an insulin pump, continuous glucose monitor (CGM), someone checking their blood sugar, or someone giving themselves an insulin shot, please ask them first if you can ask questions about their condition. Most likely, they would be happy to answer any questions that you have.”

Michl sees diabetes research as a continuing focus area for her own research because of the hope that it brings not only her, but everyone who is affected by diabetes. Knowing how far science has already come for diabetes, Michl also sees the unique opportunity to put her stamp on its future.

“100 years ago, type one diabetes was a death sentence. We have come a long way since, and the life expectancy gap between people with and without type one diabetes is improving. I am proud of UAB’s diabetes research, and I hope that we are able to continue innovating and forging the path to a better life for all people affected by diabetes,” said Michl.

The UCDC is a University-Wide Interdisciplinary Research Center comprised of over 200 faculty members from 10 different schools and many departments. It also serves as the umbrella for various research programs and awards; including the prestigious P30 Diabetes Research Center (DRC), U01 Human Islet Research Network (HIRN) grants from the National Institute of Health (NIH) and several research core facilities.