Diabetes and Diabulimia: What You Need to Know

It’s no secret that, as a society, we’re pretty obsessed with weight. It’s nearly impossible to turn on a television, flip through a magazine, or even walk down the street without being bombarded by advertisements for weight loss supplements. Diet foods that boast all the flavor and half the fat/calories/carbs/sugar/gluten. Gyms and workout programs that promise a better life.

It’s a lot to take in.

It’s no wonder that with this emphasis on achieving the “perfect” body (what does that mean, anyway?) that an estimated 10-15% of Americans suffer from some form of eating disorder. But did you know that there is a growing body of research that suggests women with type 1 diabetes are nearly twice as likely to develop an eating disorder as women who are not diabetic? You might be surprised to learn that there’s even an eating disorder unique to people who suffer from type 1 diabetes: diabulimia. And while women are diagnosed with diabulimia at a higher rate, men are also affected by this dangerous condition.

Photo Credit: Adobe Stock/Photographee.eu
Photo Credit: Adobe Stock/Photographee.eu

What Is Diabulima?

Diabulimia, also known as ED-DMT1, is a condition wherein individuals intentionally skip, delay, or drastically reduce their insulin dosage for the purpose of maintaining or losing weight. Because insufficient insulin levels prevent glucose from either being used or stored in fat cells, it is instead excreted through urine, which prevents weight gain.

While diabulimia might be easy-to-hide and a seemingly effortless way of controlling weight, it’s also incredibly dangerous.

Photo Credit: Adobe Stock/mathom
Photo Credit: Adobe Stock/mathom

Health Risks of Diabulimia

  • Heart attack
  • Stroke
  • Exhaustion
  • Diabetic ketoacidosis, coma
  • Early-onset co-morbidities (i.e. atherosclerosis, high cholesterol)
  • Decreased cognitive function
  • Gastroparesis
  • Complications from diabetes (i.e. retinopathy, neuropathy, nephropathy, peripheral arterial disease)
  • Vascular disease
  • Gum disease
  • Steatohepatitis
  • Irregular periods, infertility
  • Yeast infections, staph and other bacterial skin infections
  • Muscle loss
  • Death
Photo Credit: Adobe Stock/skyfotostock
Photo Credit: Adobe Stock/skyfotostock

Symptoms of Diabulimia

  • Unexplained weight loss or fluctuations, possibly despite eating more (particularly sweets and carbs)
  • Fatigue
  • Hyperglycemia
  • Hair loss
  • Dry skin
  • Frequent thirst/urination
  • Frequent bladder and/or yeast infections
  • Irregular periods
  • Consistent A1C level of 9.0 or higher, particularly when not reflective of recorded blood glucose levels
  • Preoccupation with weight and body image, anxiety about being weighed
  • Preoccupation with nutrition content of food, beyond what is necessary for diabetes management
  • Excessive exercise
  • Breath and urine that smells of acetone (nail polish remover)
  • Delay in puberty
  • Potassium and/or sodium deficiency
  • Unusual food rituals (i.e. hiding food, eating in secret)
  • Desire for secrecy surrounding management (i.e. testing)

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Treating Diabulimia

Treatment of diabulimia typically involves incorporating a mental health professional into your diabetes health care team. He or she should have knowledge of both eating disorders and diabetes. If you or someone you know may have diabulimia, consult your physician immediately.

For more information, contact the National Eating Disorders Association (NEDA) at 1-800-931-2237.

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