Diabulimia is an eating disorder that only affects people with type 1 diabetes. It is also known as type 1 diabetes with disordered eating (T1DE). It occurs when someone cuts back on or quits using insulin to help them lose weight. Other behaviors, such as restricting your diet, over-exercising, binge eating, making yourself sick, and using laxatives to control your weight, can also take place simultaneously.
How widespread is Diabulimia?
People with type 1 diabetes are the only ones that experience diabulimia. It affects both children and adults. However, it is more prevalent in young adults and adolescents, especially girls.
According to research, up to 30% of persons with type 1 diabetes are thought to have eating disorders. People with type 1 diabetes are two times more likely to have eating disorders than those without the disease.
What are the causes of Diabulimia?
All eating disorders, including diabulimia, are complex medical diseases. Hence, there is no single cause and it can arise from various reasons, including:
- Diabetes fatigue
- Constant and obsessive attention to diet, particularly the number of carbs
- Desire for self-control
- Concerns about one’s appearance
- Weight gain during initial diabetes diagnosis and treatment
- A desire to decrease weight
- Environmental and cultural factors
- Peer pressure
- Emotional well-being
Understanding that diabulimia or eating disorders, in general, can develop in various ways is crucial. Getting help is critical if you or a loved one exhibits the warning signs and symptoms along with diabetic burnout.
What are the symptoms and telltale indicators of Diabulimia?
Diabulimia has several emotional, behavioral, and physical indications and symptoms. These are as follows:
A. Physical signs and symptoms:
- Weight reduction that has not been tracked and accounted for
- Frequent urination
- Unceasing thirst
- Occurrences of diabetic ketoacidosis (DKA) or nearly-DKA bouts without a known etiology
- Recurrent vaginal yeast infections
- Recurrent urinary tract infections
- Diminished vision
- Dry skin and hair
B. Behavioral indicators and symptoms
- Under-bolusing or not bolusing enough insulin during meals
- A growing disregard for diabetic control
- Skipping appointments scheduled with doctors
- Uneasiness when administering insulin or checking blood sugar in front of others
- Infrequently filled prescriptions for insulin
- Sleeping more than normal
C. Emotional and psychological warning signs and symptoms
- Anxiety that insulin will lead to weight gain
- Worry over one’s appearance
- Experiencing fatigue from managing diabetes
- Aversion to hypoglycemia because it requires eating to cure low blood sugar levels.
- Anxiety and depression
- Having mood swings or feeling angry
- Having a preoccupation with food, calories, and diets
Due to their tendency to be private illnesses, eating disorders are generally challenging to diagnose. Many sufferers of eating disorders choose not to seek help on their own. This may be especially true for those with Type 1 diabetes and diabulimia because persons with diabetes frequently worry that their families or loved ones would accuse them of not managing their condition properly.
Due to this, a large number of diabulimia sufferers go undetected.
In general, if a person has an A1c of 9.0 or higher and has experienced multiple episodes of diabetes-related ketoacidosis or near-DKA without another apparent cause, such as a malfunctioning insulin pump site or accidentally using expired or spoiled insulin, healthcare professionals and family members may suspect diabulimia.
Seeking help and reaching out to your loved ones
The control of diabetes is not always simple. Additionally, dealing with an eating condition like diabulimia might make things more difficult. You could feel guilty for keeping it a secret from the people you care about.
It can be challenging to ask for assistance but it is necessary and this is the first step in addressing the issue. You won’t be working alone and will have someone to share the challenges you are experiencing. It will prepare you to seek guidance and care from a healthcare provider.
The following strategies are typically used:
- Hospitalization or a medical examination
- Nutritional counseling
- Diabetes education
Is it possible to stop Diabulimia?
Even though not all cases of diabulimia can be prevented, it’s beneficial to begin treatment as soon as someone exhibits symptoms.
Teaching and promoting good eating practices and realistic views on food and body image may also help stop the onset or worsening of eating disorders and diabulimia. Additionally, it’s crucial to encourage someone to manage their diabetes and to give them the right diabetes knowledge and support.
The bottom line
Like other eating disorders, diabulimia worsens over time if untreated. The better the outcome, the sooner the condition is identified and treated.
Diabulimia sufferers can quickly move back to proper diabetes management routines and a healthy weight. Support from friends and family helps guarantee that a person with diabulimia receives and follows through on the necessary treatment.
Dr. Ahmed is licensed by the General Medical Council, United Kingdom, and the Pakistan Medical Commission, Pakistan. With three years of experience, he has dealt with all kinds of diabetic patients and managed them with counseling and prescriptions. He is about to start his journey as a Junior Clinical Fellow in spinal surgery and orthopedic surgery in the United Kingdom.