Diabetes and Eating Disorders
Find out the signs and causes, and test yourself
Eating behavior is rarely straightforward for the person with diabetes. February 23rd marks the start of National Eating Disorders Awareness Week, so this article asks the question, "what turns ‘everyday' challenges with food into an eating disorder?"
Put simply, an eating disorder is diagnosed if your attitude towards food causes you to change your eating habits and behaviors in a way that may cause damage to your health. One type of eating disorder that is specific to people with diabetes who use insulin is the reduction or omission of insulin. This behavior is often referred to as ‘diabulimia' in the media. By decreasing, delaying, or completely omitting prescribed insulin doses, a person with diabetes can induce hyperglycemia and rapidly lose calories in the urine in the form of glucose.
Insulin omission can be done in quite a secretive way, so it often goes undetected by healthcare professionals. Unfortunately, it can also easily be misunderstood and the patient labelled ‘non-compliant' with treatment. However, if you are being ‘creative' with your insulin doses, you are actually likely to be struggling with an eating disorder.
Signs to look out for that may suggest insulin omission:
- Recurrent episodes of diabetic ketoacidosis (DKA)/ Hyperglycaemia
- High HbA1c
- Frequent hospitalizations for poor blood sugar control
- Delay in puberty or sexual maturation, or irregular periods
- Frequent trips to the toilet
- Frequent episodes of thrush/urine infections
- Nausea and stomach cramps
- Loss of appetite/eating more and losing weight
- Drinking an abnormal amount of fluids
- Delayed healing from infections/ bruises
- Easy bruising
- Dehydration and dry skin
- Dental problems
- Blurred vision
- Severe fluctuations in weight
- Fractures/bone weakness
- Anemia and other deficiencies
- Early onset of diabetic complications, particularly neuropathy, retinopathy, gastroperisis and nephropathy
- Anxiety/distress over being weighed at appointments
- Fear of hypoglycemia
- Fear of injecting/extreme distress at injecting
- Injecting in private/out of view
- Avoidance of diabetes-related health appointments
- Lack of BS testing/reluctance to test
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Yesterday I had an appointment with the new endocrinologist that I'm trying now that I've moved and "settled" in a place. Dr. M was not exactly what I expected, although I am still uncertain what I really thought she would be. The appointment was neither bad nor good and I am feeling very undecided as to how I plan to proceed. I received Dr. M's name from a friend/CDE/fellow type 1 in the community who actually has a practice with her husband. Their practice is concierge only and...