Type 1 diabetes is a serious condition that requires insulin therapy in order to survive. Without insulin, Type-1 diabetics can suffer serious complications that include heart disease, blindness, nerve damage, kidney damage and even death. Luckily, insulin therapy allows Type-1diabetics to live long, healthy lives, but one of the side effects of insulin is weight gain. This unwanted weight gain can lead some diabetics to develop a dangerous practice called diabulimia: deliberately manipulating or skipping insulin doses in order to lose weight.
Although it’s not officially recognized as an eating disorder, diabulimia is just as dangerous as “official” eating disorders and mimics many of the same symptoms of bulimia nervosa. Instead of purging food though vomiting or laxatives, diabulimics will purge through the calorie and fluid loss achieved by restricting insulin. Without enough insulin, the body is unable to use food for energy, starts to break down muscle and fat, and tries to get rid of unused glucose through urination. This results in dramatic weight loss, but can also cause a life-threatening condition called ketoacidosis (a condition in which the blood becomes acidic and the body becomes severely dehydrated).
The American Diabetes Association predicts that 30 to 40 percent of female teens and young female adults with diabetes alter or skip insulin to control their weight. Here are the warning signs of diabulimia and how to get help today.
Diabulimia: The Warning Signs
Diabulimia shares many of the same patterns as bulimia nervosa and other eating disorders, in addition to signs of insulin manipulation. The vicious cycle of diabulimia usually begins when the individual restricts his or her diet or skips meals with the intention of losing weight, followed by bingeing in order to overcompensate for their severe calorie reduction. The guilt and shame over over-eating then leads the individual to limit their food intake and avoid taking insulin in order to lose weight from the binge. Someone with diabulimia may also hoard food, have irregular or absent menstrual cycles, avoid doctor’s appointments for glucose monitoring, and require frequent emergency room visits for diabetic ketoacidosis (DKA). Weight loss, excessive thirst, frequent urination, nausea, fruity-scented breath (a sign of DKA), loss of blood sugar control, and decreased attention to blood sugar monitoring or insulin doses are also signs that diabulimia may be present.
According to the American Diabetes Association, other common warning signs of diabulimia are:
* A preoccupation with weight or dieting, even without actual weight loss.
* Label reading beyond what is necessary for insulin dosing.
* Increased isolation and a desire to be left alone, especially during mealtime.
* Obsession with exercise, including exercising in secret or at odd hours.
* Consistently high hemoglobin or A1c values that are much higher than what daily glucose values recorded in his or her logbook would suggest.
Diabulimia: The Dangers
Like all eating disorders, diabulimia has serious consequences, but the added physical stress of restricting insulin is especially dangerous. According to a study in the journal Diabetes Care, diabetics who restrict their insulin in order to lose weight are not only more likely to develop complications such as kidney disease and foot problems, but are also 3.2 time more likely to die and die an average of 13 years younger than those who don’t restrict insulin. Another long-term study showed that teenagers with Type 1 diabetes who misused insulin for weight loss had serious medical consequences in adulthood that included blurred vision, blindness, kidney failure, and foot ulcers that required amputation.
Diabulimia: Get Help Today!
Diabulimia is a very serious condition that can potentially be fatal. If you or someone you know is exhibiting any of the warning signs of diabulimia, don’t wait — get help right away. For some, inpatient treatment may be necessary in order to achieve metabolic control and safely help the patient return to normal levels.
For those who don’t immediately need hospitalization, a comprehensive approach to treatment will yield the best results. A successful treatment plan can be mapped out by an endocrinologist, psychotherapist and registered dietitian. An eating disorder treatment facility can put you in the care of professionals who are experienced in helping diabetics safely recover from diabulimia.