How To Spot Diabulimia

5. Missing or avoiding medical appointments

It’s hard to hide unhealthy behavior from a doctor, and someone struggling may find excuses to change or cancel appointments. They may also show up to appointments without their glucose meter or accurate records of their eating and insulin dosing. Someone might downplay the importance of their diabetes care or say they can handle things on their own.

6. Leftover insulin

If someone isn’t taking their prescribed insulin, the extra dosage will pile up. If they don’t have a straight answer for why they have leftover insulin, they could be struggling.

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7. Questionable blood glucose readings

It is possible to fake glucose readings. Young people may fake readings if they are frustrated with their parents asking for their numbers all the time or if they want to hide something else, like diabulimia. If someone’s numbers are suspiciously perfect, they won’t test in front of anyone, or if readings are inconsistent with HbA1c, there could be something going on.

8. Fear of lows

A person who is very concerned about low blood sugar, but not high blood sugar, may be tuned in to the fact that low blood sugar won’t cause the body to start burning fat like high blood sugar will. But both conditions are dangerous, and while high blood sugar will cause the body to burn fat, it does so dangerously and also puts the body on the fast track for diabetes complications, including diabetic ketoacidosis.

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9. Other signs

Other signs might include neglect of or secrecy about diabetes management, unexplained weight loss, nausea or vomiting, frequent thirst and urination, repeated diabetic ketoacidosis episodes, irregular menstration, frequent bladder or yeast infections, persistent lack of energy, and blurry vision.

It’s important to remember that none of these signs are a definite indicator that someone has diabulimia. They could be dealing with other physical or mental health issues. It’s important to proceed with caution and compassion when talking to someone about your concerns.

Treatment options and tips

Someone dealing with diabulimia may need inpatient treatment. The frequent and extreme high blood sugar associated with the condition greatly increases the risk of serious diabetes complications as well as ketoacidosis, which could be immediately deadly.

Outpatient treatment will likely require a combination of treatment from endocrinologists, psychotherapists, dietitians, and eating disorder experts. Support from friends and family will also be vital.

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It may seem like a good idea to tell someone that they look great, or, “You’re not fat!” But since eating disorders stem from an unrealistic idea of body image, someone may not be able to accept compliments as the truth. Weight-focused compliments and encouragements may simply help to shift their focus back onto their weight. Help them by shifting the focus away from weight completely, and, if you’re directly involved in their treatment, finding others ways to track progress besides the number on the scale.

Finally, it’s tempting to want to warn someone struggling of the long-term risk of high blood sugar like blindness and kidney damage. But to someone struggling, the risks may seem too far away to be concerned about, or the risks may seem worth it in exchange for short-term weight loss. Short-term motivators, like reducing fatigue and nausea, being able to perform at work or in sports, and maintaining muscle mass, may be more inspiring.

Any eating disorder is heartbreaking and potentially dangerous. Diabulimia is especially dangerous because it’s so easily disguised as symptoms of diabetes. Someone struggling will need both professional help and help from a network of supportive friends and family members. Remind your loved one, or yourself, that they are worth every single insulin dose.

Stay healthy, friends.

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