Jan 16, 2013

"Diabulimia" in Type 1 Diabetes

According to the National Eating Disorders Association, eating disorders — such as anorexia, bulimia and binge eating disorder — include extreme emotions, attitudes and behaviors surrounding weight and food issues. Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.

Women with type 1 diabetes are more than twice as likely to develop an eating disorder than age-matched women without diabetes.

Eating disorders in type 1 diabetes such as "diabulimia," as it is known in the popular press, represent some of the most complex patient problems—both medically and psychologically.
Women with eating disorders and diabetes typically struggle with symptoms similar to those of women with eating disorders who do not have diabetes.  However, they exhibit a very dangerous symptom of calorie purging in the form of insulin restriction.
This condition is characterized by weight and body image concerns that lead to the mismanagement of diabetes.

The NHS National Diabetes Audit says a high proportion of women aged between 15 and 30 are skipping insulin injections to lose weight. Now a charity wants diabulimia, as it is known, officially recognised as a mental health condition.

"Between 1 April 2010 and 31 March 2011, 8,472 people included in the NDA [national diabetes audit] were admitted to hospital in the UK for diabetic ketoacidosis."

Recognize eating disorders in diabetes

Warning signs may include:
  • unexplained elevations in A1C values
  • repeated problems with diabetic ketoacidosis (DKA), which can be fatal
  • extreme concerns about weight and body shape
  • change in eating patterns
  • unusual patterns of intense exercise (sometimes associated with frequent hypoglycemia)
  • amenorrhea (skipping monthly menstrual periods)

Understand the medical risks associated with eating disorders and diabetes

  • higher A1C levels
  • higher risk of developing infections
  • more frequent episodes of DKA
  • more frequent hospital and emergency room visits 
  • higher rates and earlier onset of diabetes complications - nerve damage, eye disease, kidney disease and possible heart disease


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