Diabulemia is a term for a rather uncommon eating disorder that affects people with Type 1 diabetes. Like anorexia and bulimia, the disorder can affect anybody but is more prevalent among girls and women.

People with Type 1 diabetes produce little or no insulin, so they must use insulin regularly to control blood sugar levels. Although necessary to keep the numbers in the normal range, insulin encourages storage of fat and may result in weight gain.

Diabulemia describes a disorder in which people intentionally skip doses, often taking just enough insulin to function and avoid the emergency room.

Health Risks

Inadequate doses of insulin may jeopardize health in a number of ways, some obvious and some not so apparent, including:

  • Severe hydration
  • Muscle loss
  • Excessive thirst
  • Skin infections
  • High glucose levels
  • Confusion
  • Indigestion
  • Yeast infections
  • Neuropathy in feet and hands, sometimes leading to amputation
  • Retinopathy
  • Electrolyte imbalance
  • Elevated cholesterol
  • Weakness and exhaustion
  • Glucose in the urine
  • Artherosclerosis
  • Peripheral artery disease
  • Osteoporosis
  • Kidney disease
  • Coma
  • Stroke
  • Death

While diabulemia is familiar to endocrinologists and other medical practitioners familiar with diabetes, it hasn’t yet been recognized as a medical or psychiatric condition and isn’t well known by doctors or general practitioners. As a result, it often goes untreated.

Like other eating disorders, diabulemia often stems from anxiety, depression and poor body image. Often, people with the disorder have already been diagnosed with bulimia or anorexia. Sometimes, the disorder is triggered by a rigid focus on food or the many other life changes that accompany the difficult diagnosis of Type 1 diabetes.

Signs and Symptoms

Diabulemia can cause A1C levels to soar to dangerous levels of 9.0 and above, and it may remain at those levels. Other signs and symptoms that a person may be suffering from the diabulemia include:

  • Depression and mood swings
  • Frequent yeast and bladder infections
  • Unhealthy preoccupation with weight and body image
  • Unexplained weight loss
  • Low potassium levels
  • Low sodium levels
  • Increased appetite and cravings for sweets
  • Secrecy about use of insulin or blood sugar levels
  • Frequent urination
  • Skipped doctor appointments

Treating Diabulemia

If you are struggling with diabulemia, or if you suspect somebody you care about may have an eating disorder, seek eating disorders treatment as soon as possible. The longer you wait, the greater the risk of serious, irreversible health problems.

Effective treatment for diabulemia involves a multi-disciplinary team of professionals that includes an endocrinologist or other physician, dietician, psychologist or psychiatrist, and sometimes rehab for eating disorders.

Eating disorders and substance abuse often go hand-in-hand, a situation known as co-occurring disorders or dual diagnosis. Treating two disorders is difficult, but high quality drug and alcohol treatment centers with experienced counselors can help.

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