DiabetesGPs have been warned to be on the look-out for ‘diabulimia’, or Eating Disorder-Diabetes Mellitus Type 1 (ED-DMT1), which is seen by some as a secret weapon for weight loss.

By restricting or reducing the amount of insulin the person injects, they can eat just about anything they want and control their weight. Yet the practice is risky. Restricting the insulin intake leads to high blood sugar and a build-up of ketoacidosis and complications such as blindness, kidney disease, heart disease and nerve damage.

The warning comes following a recent study that revealed that nearly 40% of young girls with Type 1 diabetes may develop an eating disorder at some point. Findings and information on identifying such diabulimia will be presented at the American Association of Diabetes Educators (AADE) Annual Meeting in New Orleans by diabetes educators Lorraine Platka-Bird and Marcia Meier, RN, CDE.

“Eating disorders and uncontrolled diabetes each are dangerous by themselves, so having both is a double whammy,” said Platka-Bird. “Treating the diabetes without treating the eating disorder is like putting a band aid on a bullet wound. That’s why it’s vital that patients with diabulimia receive help from a treatment team that includes both a diabetes educator and an eating disorder specialist.”

Those who treat people with type 1 diabetes should look for these warning signs of ED-DMT1 in any individual but particularly teenage girls and young women. Symptoms include:

  • Poor metabolic control
  • Weight loss
  • Recurrent hospitalisations – people with diabulimia typically have frequent incidences of diabetic ketoacidosis, often resulting in hospitalisation
  • Lapses in testing or long stretches between appointments
  • Fear of hypoglycaemic lows
  • Dry skin and loss of hair – unhealthy weight loss can cause skin to become drier and hair to fall out
  • Standard symptoms of diabetes – excessive urination, extreme thirst and constant hunger
  • Classic symptoms of eating disorders – such as excessive exercise, fatigue and lack of a regular menstrual period.

“It’s important for medical professionals to identify patients who may have eating disorders in addition to diabetes,” said Asha Brown, 30, a patient of Meier’s who will speak at the AADE meeting about her experiences. “It’s OK for them to acknowledge that they don’t have the resources to treat these patients and refer them to those with expertise, such as diabetes educators."

Treating the combination of diabetes and an eating disorder requires professional help for both conditions.