Diabulimia

Diabulimia is the common term for when someone with Type 1 diabetes uses insulin omission as a process for weight control. Eating disorders present in different forms and with more severe consequences. Omitting insulin puts people at risk of Diabetic Ketoacidosis, which is fatal if left untreated.

Some people develop symptoms of anorexia nervosa and this also has an impact on diabetic control. The nutritional consequences of starvation on the brain and body are more marked when insulin/glucose control is suboptimal.

What does type 1 Diabetes have to do with eating disorders and mental health conditions?

It is estimated that 40 percent of Type 1 females aged 15—30 regularly omit insulin for weight control. The combination of diabetes and an eating disorder produces a serious, pervasive and complex psychiatric condition and should be treated as such, with understanding & compassion but also with urgency as per NICE guidelines. Complications include blindness, limb loss, neuropathy blindness and fatality .

ED-DMT1, Co-morbid Anorexia & Bulimia

ED-DMT1 (Eating Disorders in Diabetes Mellitus Type 1) is an umbrella term to describe a multitude of eating disturbances in Type 1 diabetes . Current research suggests that those with Type1 Diabetes are twice as likely to develop anorexia or bulimia.

Treatment for this condition is complex and requires good physical and psychological care. Psychological therapy which relies on a brain which can learn and reflect is less effective if brain function is compromised by poor diabetic control. Also, if diabetes professionals ignore emotions around food and body shape then diabetes education will be ineffective.

Symptoms    

  • Recurrent episodes of hyperglycaemia
  • Recurrent episodes of hypoglycaemia
  • Frequent hospitalisations for poor blood sugar control
  • Delay in puberty or sexual maturation or irregular menses / amenorrhea
  • 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
  • Hair loss
  • Delayed healing from infections/ bruises
  • Easy bruising
  • Dehydration and dry skin
  • Dental Problems
  • Blurred vision
  • Severe Fluctuations in weight/ Severe weight loss/Rapid weight
  • Gain/Anorexic BMI
  • Fractures/ Bone Weakness
  • Co – occurrence of depression, anxiety or other psychological disturbance such as Borderline Personality Disorder
  • Anxiety/ distress over being weighed at appointments
  • Frequent Requests to switch meal plans
  • Fear of hypoglycaemia
  • Fear of injecting or extreme distress at injecting

Recent research shows that not only are females who have type one diabetes at twice the risk of developing anorexia or bulimia, as many as 40pc of 15 to 30 year olds regularly omit insulin.

Treatment

We provide a unique service for diabetics with eating disorders (DWED) with psychiatrists in the diabetes teams and eating disorders teams bridging physical and psychological care. We are involved in developing and testing new interventions in combination with the charity DWED (Diabetics with Eating Disorders).

For more information

For more information on diabulmia you can visit the Diabetics with Eating Disorders website: www.dwed.org.uk

Search for eating disorder services using our clinical service finder

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