Diabulimia can be life-threatening, so why is more not known about it?

Eating disorders are an increasing problem for people with diabetes. The emotional burden of diabetes can make it all too easy for eating disorders to develop, but quite often not enough is known about them.

Diabulimia, a term coined to represent diabetic bulimia, is one particular eating disorder that requires greater awareness. Diabulimia predominantly affects young women with diabetes, and is defined as the intentional skipping of insulin injections in order to lose weight.

Diabulimia is not officially recognised as a medical condition in the UK, but it is known to increase the risk of diabetic complications in people younger than 30.

Diabulimia typically affects people with type 1 diabetes, and is as much an issue of body image as an issue of diabetes. Young women discover that missing insulin injections can help them lose weight. The condition can affect some men as well.

Patients may be able to achieve weight loss this way, but their blood glucose levels will climb far too high. In the short term, this can cause typical symptoms of hyperglycemia, such as blurred vision and being abnormally tired, but also diabetic ketoacidosis (DKA), which is much more serious.  In the medium to long term, prolonged hyperglycemia increases the risk of complications such as retinopathy, neuropathy, nephropathy and blindness.

One user on the Diabetes Forum recently discussed her battle with diabulimia, and is now committed to raising awareness about the condition.

Sarah Pench (sarahpench) was diagnosed with type 1 diabetes in October 2010. Having been told by her doctor that she needed to lose weight, stop smoking and exercise more, Sarah was still drinking excessively without ever quenching her thirst, and had lost two stone within a month.

It was only when her work colleague, who also had type 1 diabetes, tested her blood sugar that Sarah was admitted to hospital and eventually diagnosed.

After 12 months, Sarah was struggling to accept her diagnosis. “My brain could not process what was actually happening to me,” she said.

A holiday to Spain one month before her diagnosis left her feeling insecure about her body, and envious of women with skinny figures.

“I have omitted insulin and seen the change in my weight going from ‘beach whale’ to today’s standard perception of ‘normal’, but at what price? Feeling like I’m gasping for air as the ketones rise, all to look a certain way.”

Sarah added that having diabulimia is a constant battle in which you’re choosing to be thin or healthy. “That’s the horrible reality of diabulimia.”

Earlier this year, a friend of Sarah’s who had also suffered from diabulimia died due to diabetes-related complications. This convinced Sarah to re-evaluate her own health and try to raise awareness as to how dangerous diabulimia can be.

“Diabulimia is not a recognised condition in the UK yet a massive amount of diabetics suffer with it,” she said. “How are we supposed to help people with diabulimia if we do not know about it?

“I hope posting this encourages us all to be open and talk about how [we] are feeling. We all battle every day but together we can be our own army and maybe just maybe win the war together.

“I learnt the hard way by having someone taken away from me that it doesn’t have to be you. Diabulimia is a condition that together I hope we can fight against.”

Experts predict that up to one third of young women with diabetes could be suffering from diabulimia. These figures are alarming, especially given the severity of complications that can develop.

Without greater awareness being raised, diabulimia could continue to affect young women and men who don’t understand how it is damaging them.

The consequences of diabulimia are dire, but if the condition can be identified and treated faster, a generation of young people with diabetes could yet learn how to live much healthier and happy lives.

Do you know someone who you think might be suffering from diabulimia? Raise awareness by sharing your comments in the Diabulimia Support thread of the Diabetes Forum. This new thread is a place for people with diabulimia to find support in an area without bias or prejudice.

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About the author

Jack Woodfield

Jack is Editorial Manager of Diabetes.co.uk. He works hard, plays fair and sleeps whenever possible. He has type 1 diabetes, doesn't mind being called a "diabetic", and once won a talent show for dancing to Dario G’s 1997 hit “Sunchyme”.

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