Diabulimia Dangerous Practice Among Type 1 Diabetes Patients

Diabulimia and restricting insulin use

Updated March 30, 2015: People with type 1 diabetes do not produce insulin, so they must take insulin injections to stay alive. Some type 1 diabetes patients, however, are engaging in a dangerous practice called diabulimia in which they restrict their insulin in an attempt to lose weight.

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A new report in Metro (March 30, 2015) highlights the dangers of diabulimia as revealed by a young woman named Stacey Williams from West Sussex in Great Britain, a type 1 diabetic who began the dangerous practice during her teen years because she was being bullied in school for her weight. Unfortunately, when she skipped her insulin injections, she developed hair loss, nerve damage, and eventually needed surgery to save her eyesight. Today she lives with terrible muscle pain that prevents her from exercising, and she needed expensive hair pieces to restore her hair.

Diabulimia is not new

A quick review of the medical literature reveals few peer-reviewed articles on diabulimia, with one dated 2007 entitled "'Diabulimia' a growing problem among diabetic girls." But the scarcity of literature does not mean this practice is not dangerous nor uncommon.

In fact, a study published in Diabetes Care in 2008 reported that out of 234 women with type 1 diabetes, 30% said they had restricted their insulin intake at some point in order to lose weight. An 11-year follow-up of these women showed that those who had restricted their insulin were more likely to experience diabetes complications and also had a shortened lifespan and increased risk of death.

Video and research on diabulimia
To help emphasize the dangers of diabulimia, the American College of Endocrinology has created a short video narrated by Kathryn Ackerman, MD, MPH, from Children's Hospital Boston. Ackerman not only explains what diabulimia is and the health dangers it can cause, but also talks with two people who have type 1 diabetes: a female fitness expert who was diagnosed with type 1 diabetes at age 14 and fought weight gain with exercise, and a woman who once suffered with and who subsequently overcame diabulimia.

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Because type 1 diabetes often first appears close to or during adolescence, young girls, who are the ones more likely than males to engage in diabulimia, feel pressured to be thin. This pressure, along with the increased attention to food that is necessary to manage type 1 diabetes, are risk factors for diabulimia.

According to a 2011 article in the World Journal of Diabetes, individuals with type 1 diabetes are at high risk for eating disorders. The authors also noted that those who engage in diabulimia experience "more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy."

How to recognize diabulimia
In the video on diabulimia, possible signs of diabulimia were noted and include:

  • Elevated hemoglobin A1c levels
  • Unexplained weight loss or weight gain
  • Blood sugar records that do not match HbA1c results
  • Preoccupation with body image
  • Excessive thirst and/or urination
  • Depression and/or fatigue
  • High blood sugar levels
  • Bladder and yeast infections
  • Cancelled doctors' appointments
  • Discomfort eating or taking insulin in front of others

The best way for individuals with type 1 diabetes to resist the temptation to limit their insulin as a way to lose weight is to exercise and practice healthy eating habits. Having a support team, including family, friends, medical professionals, and diabetes support groups can help people with type 1 diabetes not fall into the dangerous habit of diabulimia.

SOURCES:
American Association of Clinical Endocrinologists
Larranaga A et al. Disordered eating behaviors in type 1 diabetic patients. World Journal of Diabetes 2011 Nov 15; 2(11): 189-95
Metro. Diabetic teen admits she risked blindness and limb damage by stopping insulin injections to lose weight
Yan L. 'Diabulimia' a growing problem among diabetic girls. Nephrology News Issues 2007 Oct; 21(11): 36, 38

Image: Wikimedia Commons

Updated September 5, 2014 and March 30, 2015

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Comments

i am going thru thev same thing trying to keep my blood sugars at a level point my sugars go back and forth sometimes but i take insulin