Understanding Diabulimia

Eating disorder diabulimia associated with type 1 diabetes and insulin restriction

(RxWiki News) Diabulimia. You might have heard this new buzzword, but did you know it refers to a serious health problem?

The term "diabulimia" refers to an eating disorder in a person with diabetes (usually type 1 diabetes). A person with diabulimia purposefully decreases insulin use in order to lose weight. The term was coined in the media, but you might hear health care professionals refer to diabulimia as "Eating Disorder-Diabetes Mellitus Type 1" (ED-DMT1).

Diabulimia may occur at any age and any point after diabetes is diagnosed. It may begin due to treatment fatigue or a desire to lose weight.

Warning signs and symptoms of diabulimia include neglect of diabetes management, secrecy regarding diabetes management, anxiety about body image, and extreme exercise or diet patterns. Additional signs and symptoms include unexplained weight loss, frequent bladder or yeast infections, an A1C consistently higher than 9 percent, increased frequency of urination, increased thirst and multiple episodes of diabetic ketoacidosis (DKA).

DKA is a dangerous and serious condition that occurs when there is not enough insulin to transport ketones from the blood into the cells. This results in ketones building up in the bloodstream and making the blood acidic. Left untreated, acidic blood can damage blood vessels and organs or result in a coma.

Diabulimia is a serious condition. In an 11-year study, the National Eating Disorders Association found that patients with weight-related insulin restriction were more likely to die than those who didn’t restrict insulin.

Short-term consequences of diabulimia include slow wound healing, increased bacterial infections, yeast infections, menstrual disturbances and DKA. Long-term consequences include permanent damage to the eyes; stabbing or burning pain in the hands, feet, legs or arms; kidney disease; liver disease; and heart disease.

Diabulimia treatment can be challenging. It cannot be treated simply by reinforcing diabetes education or discussing the complications tied to uncontrolled diabetes. Successful treatment often requires an endocrinologist (a doctor who specializes in hormone imbalances), a dietitian and a mental health professional.

If you are concerned that you or a loved one might have diabulimia, contact your health care provider or call the National Eating Disorders Association’s toll-free, confidential helpline at 1-800-931-2237.