DIABULIMIA: The Restriction of Insulin for Weight Loss

Studies show that Diabetics are 2.5 times more likely to develop an eating disorder. Diabulimia, though not an official (DSM IV) psychiatric diagnosis, describes an emerging weight loss practice among some diabetics.

Research suggests that in addition to an increased risk of complications such as foot and vision problems, along with kidney damage, Diabulimics triple their risk of death over diabetics who do not restrict their insulin.

"People with type 1 diabetes have completely lost the ability to produce their own insulin, the hormone necessary to usher glucose into cells, where it is stored for energy. Regular injections of insulin essentially replace what the body used to produce naturally. But shortchanging insulin doses means glucose levels are not controlled ..."states Amanda Gardner in her article, "'Diabulimia' Triples Risk of Death Among Women With Diabetes."

"The repercussions of manipulating insulin in such a manner can be enormous. Patients who do this have higher blood sugar levels than are healthy, and as a result, become dehydrated, fatigued, and experience a breakdown in muscle tissue. In the long term, this condition is associated with an accelerated development of diabetic complications such as eye disease, kidney disease, and limb amputations due to vascular disearse.

While this disorder is relatively well known to endocrinologists that treat a large number of patients with type 1 diabetes, it is not often recognized by primary care providers or by family members.

If you are a family member of someone with type 1 diabetes and you see patterns of behavior that are concerning, bring it to someone's attention. The long term damage that can occur can be profound, and early acknowledgment of the behavior along with early intervention can make a world of difference," says Dr. Ruchi Mathur, M.D. FRCP (C).

According to Mayo Clinic endocrinologist Maria Collazo-Clavell, Md. a Diabulimic may exhibit the following warning signs:

• Weight loss
• Excessive thirst
• Frequent urination
• Low energy
• Nausea
• Fruity-scented breath (a sign of diabetic ketoacidosis)
• Decreased attention to blood sugar monitoring or insulin doses
• Loss of blood sugar control

"Often, diabulimia is suspected by a friend or parent before the person who has diabetes admits that anything is wrong. If you have diabulimia or you suspect that a loved one has diabulimia," she warns, "seek help immediately. Ideally, treatment will involve specialists in both eating disorders and diabetes. Early intervention may save a life."

See "Eating Disorder Help" in sidebar for listing of Helpful Hotlines, Organizations, and Websites

Information compiled from the following sites:
http://www.medicinenet.com/script/main/art.asp?articlekey=87460
http://www.medicinenet.com/script/main/art.asp?articlekey=81960
http://www.mayoclinic.com/health/diabulimia/AN01737