Diabetes

Updated 17 November 2017

The dangerous reason why diabetics are skipping their insulin

What is this new eating disorder that can potentially kill diabetics? We take a look.

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On 25 September 2017, the BBC reported on the suicide of 17-year old Megan Davison. She hanged herself and revealed the true nature of her distress in a long suicide note – she had "diabulimia" and was struggling to control the disorder.

Megan was reducing her insulin in an attempt to lose weight. This was taking a toll on her health and emotions. Her parents had no idea what she was doing.

Eating disorders and diabetes are rarely uttered in the same sentence. But a new eating disorder is taking its toll on women suffering from type 1 diabetes. Diabulimia, a compound word made up of “diabetes” and “bulimia” is not an official medical term, yet this condition is deadly.

What exactly is diabulimia?

According to the Diabetes Organisation UK, diabulimia refers to the situation where a diabetic deliberately and regularly reduces the amount of insulin they take out of fear of gaining weight. The long term impact is hyperglycaemia and weight loss.

There are other reasons why a diabetic will not take the correct amount of insulin, such as the fear of hyperglycaemia or the underestimation of how much is needed, but diabulimia specifically refers to the skipping of insulin because of weight concerns or with the goal to lose weight.

When did it become a problem?

Diabulimia is such a recent problem that proper treatment guidelines didn’t exist until 2009. Now, awareness is luckily increasing. While official statistics are not available because of the unofficial nature of this eating disorder, experts predict that as many as one in three young diabetic females might be diabulimic.

How can diabetes lead to eating disorders?

Eating disorders are often complicated to diagnose and it’s even more complicated to establish the cause in every individual case. According to the Diabetes Organisation UK, there are several reasons why diabetics can develop diabulimia. The main reason suggested is that living with diabetes type 1 can make you more vulnerable to eating disorders, as you constantly need to control what you eat, as well as reading food labels.

The additional obsession with weight might just be a by-product of a bigger problem, but just like any eating disorder, it can be extremely dangerous, especially in a diabetic, as severe hyperglycaemia may result in coma or even death.

Weight and body image may also already be an issue in diabetics since it is possible to gain weight because of the treatment insulin they need to take – insulin is a fat-storing hormone, which can lead to weight gain. The most obvious solution would then be to reduce or completely skip the insulin, which can have dire consequences.

What can happen if you don’t take your insulin?

Besides hyperglycaemia, not taking insulin as needed can result in several other effects on the body:

  • Exhaustion
  • Extreme thirst and frequent urination
  • Dehydration
  • Muscle loss
  • The inability to think clearly
  • High cholesterol
  • Bacterial skin infections
  • Eyesight damage
  • Damage to the nervous system

Signs of diabulimia

Eating Recovery Center tells parents to look out for the following warning signs in young diabetics:

  • Poor blood-sugar control
  • Unused insulin jabs
  • Recurrent episodes of hyperglycaemia
  • Secretive behaviour when needing to inject insulin or defensiveness when being asked about insulin
  • Missed doctors’ appointments or missed prescriptions
  • Restrictive or binge eating
  • Poor body-image and negative self-talk
  • Depressed mood
  • Weakening eye sight
  • Weakness and numbness in the hands and feet
  • Noticeable weight loss

When you are concerned about weight gain

There are ways to manage your weight while taking insulin. If you are concerned, see your doctor or consult a registered dietitian to talk about a suitable eating plan and ways to manage your weight:

  • Be clever about your kilojoules. Follow a healthy, balanced diet.
  • Do a form of exercise that you enjoy – aim for at least 30 minutes per day.
  • Do not skip meals.
  • Take your insulin as directed – the dangers are not worth the weight loss.

Image credit: iStock

 

Ask the Expert

Diabetes expert

Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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