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What is Diabulimia?

Diabulimia is an eating disorder in which women, men or teens with Type 1 diabetes deliberately take less insulin than their bodies need in order to control their weight. The disorder is very a dangerous way to get thin. Research has found that diabulimia raises the risk of serious diabetes complications.

What is Type 1 Diabetes?

In people with Type 1 diabetes, the pancreas stops making insulin. Without insulin, the body can no longer use food for energy. Instead, glucose from food ends up in the blood stream, causing blood sugar levels to spike. Left untreated, high blood sugar damages blood vessels that supply organs, leading to vision problems, kidney failure and nerve damage. Type 1 diabetes often strikes in the pre-teen or early teen years, a time when many young people become increasingly concerned about their weight and appearance.

What are the Signs of Type 1 Diabetes?

Lethargy, thirst, blurred vision, excessive urination, and weight loss. Before diagnosis, people with Type 1 diabetes have often gotten very thin, because their cells are literally starved for glucose.

People with Type 1 diabetes need to take insulin daily to allow the body to use the glucose in food and to keep their blood sugar at healthy levels. A side effect of insulin is weight gain. When the weight gain is unwelcome, it may prompt some with Type 1 diabetes to take less insulin than they should or skip taking it altogether.

How Common are Eating Disorders in People with Type 1 Diabetes?

According to studies girls and women with Type 1 diabetes are at a higher risk of developing an eating disorder than females in the general population. Those with diabetes have to pay a lot of attention to food at all times – carefully calibrating the impact of every snack and meal on their blood sugar so they don’t eat too much or too little, which can lead to hypoglycemia. These habits, which are needed to manage the disease and maintain health, can have the unwanted side effect of triggering anxiety related to food or other eating-related issues.

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What Happens When People with Type 1 Diabetes Stop Taking Insulin or Don’t Take Enough?

When people with Type 1 diabetics take too little insulin, glucose builds up in the bloodstream instead of entering cells. People with diabulimia do this intentionally, so that they can eat lots of high calorie foods and not gain weight. The problem is that the lack of insulin leads blood sugar to skyrocket, putting health at risk in numerous ways, including diabetic ketoacidosis (DKA), a life-threatening conditions that occurs when the liver releases ketones due to high blood sugar. The risk of diabetic complications also rises, including eye damage/vision problems (retinopathy), kidney damage or kidney failure and nerve damage (neuropathy).

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What Are the Warning Signs of Eating Disorders in Type 1 Diabetics?

Many of the signs of eating disorders in people with Type 1 diabetes are the same as for people without diabetes. Those signs include an intense fear of gaining weight, extreme concern about body shape, changes in eating patterns, dramatic weight loss, secrecy around eating, and social withdrawal.

But there are other signs that are specific to diabetics, such as an unexplained elevation in A1C levels, secrecy about insulin shots, hospitalizations because of not taking enough insulin/repeated problems with diabetic ketoacidosis (DKA). Excessive exercise associated with frequent hypoglycemia (low blood sugar) is another possible red flag.

Signs of diabulimia can also mirror the symptoms of diabetes – thirst, frequent urination and weight loss.

If you suspect someone with Type 1 diabetes is not taking their insulin or struggling with issues around eating, please contact us for a confidential consultation. Our team is experienced in treating patients with diabetes and eating disorders.

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