Diabulimia: NHS cash to treat type 1 diabetes eating disorder

[JohnEGreen]

This I think is encouraging for those affected by this eating disorder.

https://www.bbc.co.uk/news/newsbeat-47358903

 

[Deleted Account]

Great this is starting to be taken seriously by the NHS.
Shame BBC only quoted number of people aged 15 to 30 with type 1 which continues to propagate the myth it is a childhood disease. But I guess that is what you get with a quote from Juvenile Diabetes Research Foundation. In my dealings with them, I have found them completely uninterested in anyone over 30.

 

[kitedoc]

I am impressed by this news. And given the age group quoted, not only does that limit the actual truth about type 1 diabetes, as @helensaramay points out but it made me wonder, will the audience think that the rest of them die?
Nor if the former notion was clarified it there any indication about what happens to those make it through.
Or that eating disorders in diabetics are not entirely restricted to this age group.
At Christmas I attended a party put on by the local chapter of JDRF. I just did not mention my age !!! And I suspect there were others there with the "I am 30, but not really" look about them. And it was not due to the footwear, socks or any other feature !!

 

[Member496333]

Interesting and complex topic. Leaving aside any mental aspects for a moment, surely type 1 diabetics only become overweight through insulin use if they’re over-consuming carbohydrate and therefore having to use requisite higher doses? Not dissimilar to the mechanism by which everyone else gains weight, except that the insulin is exogenously administered rather than secreted naturally by the pancreas? But of course I guess there are also those who will allow their blood glucose to skyrocket as a priority over injecting even basal insulin.

Terrible condition to have to live with

EDIT: correction from bolus to basal. Terminology error on my my part. Apologies.

 

[Dillinger]

There's also an article in The Guardian about this; https://www.theguardian.com/society/2019/feb/28/diabetics-eating-disorder-diabulimia

What is so sad about being caught up by this (NUANCE alert!) is that the people who suffer from it are on the right track - i.e. it's good to reduce your insulin requirements, but they are executing that completely incorrectly. As Jim says above the solution is low-carbing, your insulin will come down and it should be easier to lose weight (albeit low-carbing isn't a magic bullet).

Obviously too little or no insulin for Type 1 diabetics is not an option; it will kill you, but you can manage you amounts down without risking your health.

 

[DCUKMod]

Interesting and complex topic. Leaving aside any mental aspects for a moment, surely type 1 diabetics only become overweight through insulin use if they’re over-consuming carbohydrate and therefore having to use requisite higher doses? Not dissimilar to the mechanism by which everyone else gains weight, except that the insulin is exogenously administered rather than secreted naturally by the pancreas? But of course I guess there are also those who will allow their blood glucose to skyrocket as a priority over injecting even basal insulin.

Terrible condition to have to live with

EDIT: correction from bolus to basal. Terminology error on my my part. Apologies.

Well, that's all ignoring things like thyroid and other hormonal issues, which are common in those with diabetes, and can increase the individual's chances of gaining weight.

T1s can only gain weight if they over eat is just over simplification, just as it is for anyone else living a real life.

 

[EllieM]

One of the issues about T1s and weight gain is that most/many T1s have a fair number of hypos, which they have to take carbs for. For those who are keeping very tight control, it is particularly easy to overdo the insulin and therefore be forced to take unwanted carbs. (eg as I was going to bed this evening my blood sugar was 4.5. I don't normally snack at bed time (am not hungry then) but I'm not going to bed at 4.5 and risk a nocturnal hypo.)
Eating disorders in general are quite a common among people who are forced onto restrictive diets for whatever reason, so diabetics are particularly prone. Diabulimia is a very unpleasant eating disorder, but most/all eating disorders are extremely unpleasant and unfortunately once one is in the throws of such an illness it can be very difficult to think rationally about food and/or insulin. Good that the NHS are trying to deal with it, though it's not at all easy to deal with and I don't think there are any magic bullets to cure this illness.

 

[Deleted Account]

Leaving aside any mental aspects for a moment

But as with all eating disorders, leaving the mental aspects aside is ignoring the problem. It is a mental issue.
And following a low carb diet is not the solution either ... it is a mental condition which needs to be treated.

 

[DCUKMod]

I'd totally agree with you there @helensaramay . As someone with a few grey cells in her head, at the time I weighed under 6st, and dropping, I knew I had to get some nourishment inside me, but I just couldn't do it.

In those circumstances, just picking up a fork and getting on with it is waaaaaaaaaaaaay easier said than done.

Unfortunately, as I see it, whilst it is absolutely fabulous that the NHS has admited it should be engaging with these disorders and is willing to do so, I still foresee issues with those suffering getting anywhere past the gatekeepers for treatment - their GPs. Sadly, GPs often just don't get it.

For the avoidance of doubt, of course there are exceptions to all rules in this regard.

 

[Member496333]

To be clear I wasn’t suggesting a low carb diet for anyone. I was merely interested in the mechanism of this condition and its relationship with insulin.

 

[Member496333]

Well, that's all ignoring things like thyroid and other hormonal issues, which are common in those with diabetes, and can increase the individual's chances of gaining weight.

T1s can only gain weight if they over eat is just over simplification, just as it is for anyone else living a real life.

I did say “overweight through insulin use” in regards to the relationship with insulin. I didn’t mean to suggest that insulin is the only reason someone can become overweight.

 

[Juicyj]

Diabulimia is a psychological condition, living with type 1 means being aware of the role of food with carb counting and taking correct insulin doses which is very restrictive, teenage years come with many trials and tribulations which test an already hormonal youngster, it only takes a few 'fat' comments to stir up anger and hate which then result in omitting insulin and seeing this as the enemy, once weight loss starts then the individual is caught in the trap of believing they look acceptable and do not question the consequences as the damage is hidden, it's a condition i'd liken to an onion in so much that there are many layers to peel back to get to the root of the cause.

The saddest part is that it very often results in long term damage with eyes, nerve issues, gastro issues so years after recovery the lingering effects of this dreadful condition still hang about.

I have a friend who's daughter suffers with this and lives in denial, it's heartbreaking to see the damage it does, not just to the individual but the amount of hurt and pain caused to family members and friends, so any support is a welcome relief as the NHS are pretty clueless in coping with this.

 

[Juicyj]

I did say “overweight through insulin use” in regards to the relationship with insulin. I didn’t mean to suggest that insulin is the only reason someone can become overweight.

A patient typically isn't over weight to start with.

 

[Robinredbreast]

This is a good link and very informative.

https://www.waldeneatingdisorders.c...-twice-as-likely-to-have-this-dual-diagnosis/

 

[DCUKMod]

Diabulimia is a psychological condition, living with type 1 means being aware of the role of food with carb counting and taking correct insulin doses which is very restrictive, teenage years come with many trials and tribulations which test an already hormonal youngster, it only takes a few 'fat' comments to stir up anger and hate which then result in omitting insulin and seeing this as the enemy, once weight loss starts then the individual is caught in the trap of believing they look acceptable and do not question the consequences as the damage is hidden, it's a condition i'd liken to an onion in so much that there are many layers to peel back to get to the root of the cause.

The saddest part is that it very often results in long term damage with eyes, nerve issues, gastro issues so years after recovery the lingering effects of this dreadful condition still hang about.

I have a friend who's daughter suffers with this and lives in denial, it's heartbreaking to see the damage it does, not just to the individual but the amount of hurt and pain caused to family members and friends, so any support is a welcome relief as the NHS are pretty clueless in coping with this.

One of the most painful things during my condition was seeing the look in my Father's eyes when he came to see me in hospital (I was living abroad a the time), effectively to say goodbye to me. (Yes, I was that ill.)

I will never, ever forget that haunted look, in a father who deeply loved his child, but could do nothing to save her.

Thankfully, we had happier times ahead. But @Juicyj , you are so right, these things aren't solo trips, for sure.

 

[Robinredbreast]

A patient typically isn't over weight to start with.

I was 8 1/2 stone and I went down to 7st 1, so very underweight and clearly ill when diagnosed, but I put it down to my Ex who had previously left.

Young people struggle so much these days with what is seen as being 'normal' trying to fit in and social media plays a big part with their self esteem and self worth so they are hit so hard, plus, being diagnosed with a life long chronic condition like type 1 diabetes and all that it entails ( 24/7) can be very hard to cope with. Self harm, in whatever form ie, physically or emotionally is a release. Bulimia and Anorexia causes so many internal body problems, it can be a killer.

 

[Juicyj]

I would just like to see it discussed more and for those who are affected by it to feel they can openly talk about it and get support for it, there are still many closed doors on the road to recovery and it's disheartening to see that even when a treatment plan is implemented that it takes too long to help the patient, whilst there is damage being done internally, it needs to be fast tracked and easily accessible for the patient.

@DCUKMod You are very brave to discuss your experiences.

 

[Robinredbreast]

This I think is encouraging for those affected by this eating disorder.

https://www.bbc.co.uk/news/newsbeat-47358903

Absolutely heartbreaking to read

 

[Robinredbreast]

Interesting and complex topic. Leaving aside any mental aspects for a moment, surely type 1 diabetics only become overweight through insulin use if they’re over-consuming carbohydrate and therefore having to use requisite higher doses? Not dissimilar to the mechanism by which everyone else gains weight, except that the insulin is exogenously administered rather than secreted naturally by the pancreas? But of course I guess there are also those who will allow their blood glucose to skyrocket as a priority over injecting even basal insulin.

Terrible condition to have to live with

EDIT: correction from bolus to basal. Terminology error on my my part. Apologies.

The mental aspect of these eating disorder's are paramount and should never be, your quote :-' Leaving aside any mental aspects for a moment' !

 

[Member496333]

“Leaving aside for a moment” means for a moment. In this instance the “moment” was to ponder the mechanism with insulin as a possiblble cause of weight gain leading to the other issues. But never mind. Note to self - don’t bother commenting in type 1 related topics, as someone is certain to misunderstand or be offended. I did open my post by saying it’s a complex topic, but hey ho.

Sorry for any confusion.