Is diabetes driving you crazy? If so, welcome to the club. In fact, a very large club.

"Diabetes Burnout: What to Do When You Can't Take It Anymore," written by William H. Polonsky, PhD, CDE, begins with this question and then tackles the answer. The conflicts, struggles and mistakes that happen to you and in your home pop up throughout this book in the stories of Mel, Leo, Regina and Lois. Through touching and often humorous stories of real persons and family members struggling with diabetes, Polonsky draws us into the underground reality of diabetes burnout which is inhabited by the "Blood Sugar Fairy," the "Diabetes Police" and a few werewolves. From this honest and whimsical view, we see how and why diabetes drives so many people crazy and how diabetes burnout develops.

Throughout "Diabetes Burnout," Polonsky helps people with diabetes focus on two additional questions:

1. Can you identify your specific problem areas in living with diabetes?
2. Will any idea on the lists of suggested coping strategies help you overcome your barriers to diabetes care?

First, Polonsky asks, "Can you identify your specific struggles-with following a healthy meal plan? With exercising? With your emotions? With your family? With your doctor?" Separate chapters focus on common barriers to following a meal plan, timing diabetes medications, monitoring blood sugars, exercising and maintaining a positive relationship with your health-care team. For each of these self-care areas, Polonsky presents a brief paper-and-pencil self-assessment, which helps the reader to identify potential obstacles, set realistic goals and develop a reasonable action plan for achieving these goals.

After identifying specific problem areas in diabetes self care, Polonsky helps the reader focus on how to find coping strategies that work. Specific strategies are suggested for coping with eating struggles, family conflicts or doctor dilemmas, and the reader is encouraged to try them out. In "Diabetes Burnout," we learn about the "werewolf syndrome" or, overeating, specifically at night, and then focus on "7 silver bullets," strategies for overcoming this common problem. Similarly, "Diabetes Burnout" asks the reader to try out strategies for "overcoming denial," "challenging your beliefs about diabetes," "getting the support you need" and "building a better relationship with health-care providers." Polonsky does not assume that this book contains the right answers for everyone. In fact, he encourages the reader to seek out professional help when confronted with the impossible-to-solve problems in their life with diabetes.

The heart of "Diabetes Burnout" is captured in two short sentences on page 15: "Perfection is not necessary. Even a small improvement in blood glucose can lead to significant health benefits." Polonsky points out how perfectionism traps patients, family members and health-care providers in a vicious cycle of unrealistic expectations for diabetes self-care, failure which blames the person living with diabetes and criticism which undermines all efforts to improve diabetes care. Patients and health-care providers are guided in the art of setting individualized, realistic goals for diabetes care.

Polonsky is an internationally recognized clinician and researcher, and "Diabetes Burnout" illustrates his strengths in both areas. As a sensitive clinician, Polonsky writes through compelling, first-person stories that will connect with even the most isolated person with diabetes. In the chapters on stress and fear of hypoglycemia, we see Polonsky's talent for translating the most recent behavioral science research into practical guidelines for patients and providers.

For the health care provider, "Diabetes Burnout" gives guidelines for intervening with the many patients struggling with burnout. Moreover, this book also offers a structure for building a life with diabetes that prevents diabetes burnout from developing in the first place. The 340 pages of this revolutionary book offer evidence-based, concrete strategies for preventing the unhealthy patterns of diabetes burnout that have trapped so many in the diabetes community. In "Diabetes Burnout," Polonsky reminds us of the wide-scale under-use of blood sugar monitoring in the last decade and the current challenges of translating the lessons of the DCCT into the diabetes community.

The prevention of diabetes burnout must be integrated into the process of introducing patients, family members and providers to the innovative diabetes medications and blood sugar monitoring technologies that are part of this new millennium.