There have been great changes in what we know about this condition, and in how it is best treated. Research has given us new medications, better glucose monitors, less painful syringes, new ways to schedule testing and medication, more convenient meal-planning techniques, safer and more widely available transplantation, and the real hope of a cure. Burnout is a possibility. The demands of diabetes self-management are mercilessly unsubtle. Today, tomorrow, and everyday after, you must perform the tasks that will keep your blood sugars as close to non-diabetic normal as possible.
Some folks do well for a time, and then lose patience with the necessary discipline.
Then they depart from good self-management, and their health suffers. All their lives, these individualists have resisted authority, public opinion, and social pressures to conform. They may be devilishly effective salesmen and negotiators, but diabetes cannot be cozened at the bargaining table. Lacking the emotional skills to deal with a disease they cannot overawe, unable to confront it in their traditional fashion, these folks are lost at sea. There are many other reasons why folks depart from good self-management, or fail to ever adopt it.