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What helps: Screen with the 2-item Diabetes Distress Scale (DDS2): "How often do you feel overwhelmed by your diabetes regimen?" Simplify regimensonce-daily basal insulin or GLP-1 RAs reduce decision fatigue Lower the bar temporarilyidentify "minimum acceptable care," not ideal care Refer to diabetes psychologythis has a biological treatment target The bottom line: Diabetes Burnout is real, common, and measurable in the HPA axis, immune system, and metabolic pathways

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