Questions regarding restrictions of insulin "diabulimia"

[Activeyoungwoman]

Have been pondering about some questions regarding diabulimia for some time now. Would like to have professionals or very well educated people answering. For the sake of other who is as curious as myself, I'm asking both for both an overall answer and one personalized to myself.
What is diabulimia?
How do people with diabulimia avoid DKA?
In what blood sugar level to the body start to shed away your own body fat? 15mmol? Higher?
Have there been any longer studies showing that diabulimia is in fact having negative impact on diabetics?
How quickly can one lose weight when restricting insulin?
Which insulin is the "ideal" one to restrict?
Should one exercise while restricting insulin - what are the effects?
Would drinking more water help with losing weight quicker/safer?

And to myself then; I was recently diagnosed with type 1 diabetes, more accurately a month ago. My symptoms were quite "severe" - I drank about 7-8 liters of water a day, had a need to pee approximately 25 times a day, was extremely fatigued and had to convince myself to stand up after being seated, had trouble sleeping, had vision blurs, lost my balance a few times a day, every time I ate I got crazy abdominal pains that lasted several hours and made me pretty much unable to function, lost 10 kg of weight, couldn't walk more than a few steps without shortness of breath and so on. This evolved gradually upon me, it wasn't something I even thought about much and when I think back I believe it has been going on for at least six months prior to my diagnosis. Despite an overall feeling of not being well and all these symptoms I forced myself to maintain my normal life and thought I was just "lazy" when my body tried to stop me. I ended up at my doctors just about a month ago after persuasion from my parents, mostly for my abdominal pains as they seemed to get worse. My doctor didn't think of diabetes (why the hell not?? Really, so weird!), but took some blood tests and was confused when my blood sugar was "high" and well above the forties. She took a hba1c which said 20% and that was when she realized I had diabetes. Was sent to the emergency and was hospitalized for a week. Has since then been introduced to insulin and the now normal life for myself as a diabetic.
Now to my inquiries. I have since starting on insulin gained A LOT of weight, probably around 20kgs. This feels awful, because the weight I had when diagnosed is the "ideal" for my length and body type. I am now very fat and it's really not a pleasant experience. I know the reason is that I've indulged in foods with high carbs and therefore have been taking quite a lot of insulin. So it's not a shock that I am now over weight, but I now feel fed up and ready to give up this lifestyle with high carbs and sugar. What I've been thinking though, is that if I maintain a high blood sugar level now, my body "should" eat my stored fat, right? I am in no means wanting to maintain eating carbs or sugar, so this would simply be a way for me to quickly shed my excess fat so that I then can start my healthy new life with a slimmer body and for the rest of my life have normal blood sugar levels. So basically I want to have a period with high blood sugar levels so my body eats up my fat, and when I'm down on my normal weight, proceed with a healthy diet and normal insulin injections.
What would the "optimal" high blood sugar be for this to be as "safe" as possible? I don't want to risk DKA, but risking some long-time effects I'm okay with (because I don't think anyone really knows why long-term effects show, therefore I don't really think a month or two with high blood sugar would be so harming as they assume). How much insulin and which of them (Lantus versus NovoRapid) should I take to continue to be in the highs, but not so high that I risk DKA? I've tried to read a lot on the subject but can't find answers to my questions. Is it safe to exercise while on this "diet"? Could it in fact hurry up the process? Or does it slow it down?
I am a stable young woman, with high IQ and have no reason to believe that this will turn into a long-term eating disorder, it is just a way for me to come to terms with myself and my diabetes. I am fully prepared to give up carbs and sugar from now on, I don't feel like I will miss it at all, and I just want my body to get rid of the excess fat before I start my new healthy life with the goal to maintain a perfect hba1c for the rest of my life. Please answer to your best knowledge, and consider answering for both the overall public and to my specific case. If possible, please include sources for your information and do consider explaining how you came to your expertise (are you perhaps a doctor? Etc).
(Sorry if the language isn't perfect - I am not a native English-speaker)

 

[catherinecherub]

There are more experienced people than me who will answer but for now I will bump your post up.

Having read this article it seems that you need to think very carefully about what you are doing.

Diabulimia
Diabulimia is an eating disorder which may affect those with Type 1 Diabetes. Diabulimia is the reduction of insulin intake to lose weight. Diabulimia is considered a dual diagnosis disorder: where one has diabetes as well as an eating disorder. While diabulimia is generally associated with use of insulin, an individual with diabetes may also suffer from another eating disorder as well.

Health Risks of Diabulimia

• High glucose levels
• Glucose in the urine
• Exhaustion
• Thirst
• Inability to think clearly
• Severe dehydration
• Muscle loss
• Diabetic Ketoacidosis (unsafe levels of ketones in the blood)
• High Cholesterol
• Bacterial skin infections
• Yeast infections
• Menstrual disruption
• Staph infections
• Retinopathy
• Neuropathy
• Peripheral Arterial Disease
• Atherosclerosis (a fattening of the arterial walls)
• Steatohepatitis (a type of liver disease)
• Stroke
• Coma
• Death

https://www.nationaleatingdisorders.org/diabulimia-5
http://www.joslin.org/info/Eating_Disorders_Diabulimia_in_Type_1_Diabetes.html

There are easier methods to lose weight than relying on a dangerous way to do it.

 

[phoenix]

Have there been any longer studies showing that diabulimia is in fact having negative impact on diabetics ?
.
How about the 11-year follow up study of women T1s that found that those who restricted insulin had a three-fold increased risk of mortality. Women reporting this behavior also have higher HbA1c, higher risk of developing infections, more frequent episodes of DKA, and more frequent hospital and emergency room visits than women who do not restrict insulin. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769725/

More to the point I've read too many stories of young women who eventually manage to stop doing but cannot undo the harm that they have caused to their bodies
Read some of the stories http://www.dwed.org.uk/about-us/our-own-words such as this sample

"I am one of the lucky ones who came out the other end, although I bear the scars of what I went through in the form of painful, life changing complications including neuropathy and kidney damage. Others aren’t so lucky and I now more frequently hear horror stories of people too young to die, losing their battle to this horrible illness. I now want to make sure that if others are suffering as I did,"

It is much better to learn how to control your diabetes now and learn to take the right amount of carbs/food for your lifestyle . You say that you were the right weight when diagnosed but you had lost weight to get there. Now your body is back to normal because you are able to use the energy (some of the regain will have been replacement of fluids.) Unfortunately, If you take in more than you need then like everyone else diabetic or not you will put on weight
(and yes I suspect a lot of us have odd regrets that we have lost that extremely thin figure we had just before diagnosis . We probably forget the pinched face and unhealthy look and lack of energy that we also had . I have a pair of long boots sitting at the back of my wardrobe. I loved them but will never be able to wear them again but in reality, the only reason they fitted was because I had lost all the muscle in my calves)

Please first check that you are really overweight using the scales and then check to see if you have a normal BMI. If you have gained too much then it really is so much better to lose it by cutting back your calories and becoming a bit more active.
Recently, I put on a bit of weight because an underactive thyroid made me rather inactive. I used My Fitness Pal to record my calories and got a pedometer to make sure that I was moving more. It worked and I lost the excess weight but it was a healthy gradual loss.

Your user name says that your are a young active woman. Live up to that and use active people with diabetes as role models
They don't restrict insulin, they wouldn't have enough energy .
You don't have to become quite as active as these people but it shows that diabetes doesn't have to stop you.
. http://www.teamnovonordisk.com/stories/

 

[jack412]

you don't need to make yourself sick to lose weight, if you are on a mixed fixed dose, it's too high and you're eating to your insulin and not the other way around

now you were probably under weight when you were diagnosed and the healthy weight stacks on fast and the body image doesn't have a chance to keep up and all you see in the mirror is flab when everyone else are saying how well you look

are you on basal and bolus? or a mixed single injection

if you want to lose weight, you reduce carbs which means you can reduce bolus

http://www.lowcarbdietitian.com/blog/carbohydrate-restriction-an-option-for-diabetes-management
http://diabeticmediterraneandiet.com/low-carb-mediterranean-diet/

 

[Flowerpot]

Please don't ever consider restricting insulin as a method of losing weight. You are only very recently diagnosed so please give your body time to adjust to having insulin again, Type 1's lose a lot of weight prior to diagnosis and once there is insulin in the system again there is some normal weight gain.

I am living evidence of the damage and chaos diabulimia brings about . I had anorexia and restricted insulin to control my weight. It is in no part a safe way to behave even for a short period and has dire consequences. I didn't manage to avoid DKA which is in itself life threatening and your idea to let your body eat your stored fat whilst restricting insulin is a sure way to end up with DKA. There is no "ideal" insulin to restrict, Type I is insulin dependent, it is not optional. Likewise there is no "optimal" high blood sugar, the only optimal blood sugar is normal blood sugar.

You say "you don't want to risk DKA but risking some long-time effects I'm okay with", unfortunately you don't get to pick and choose which complications you prefer. I'm partially sighted with kidney disease and a collapsed ankle joint from nerve damage all brought about by restricting insulin, not so great to live with. Please don't consider doing it, I am living with the consequences 20 years later with things still going wrong.

I arrive at my findings through 37 years of Type 1. I'm certain any medic would give you a much more blunt and to the point answer. Please don't go about weight loss in this way, there are good ways to control the amount of carbs you eat plus exercising all whilst maintaining a healthy blood sugar. Give your body time to adjust after diagnosis and set about any weight loss whilst maintaining a normal blood sugar as your priority. Go about it the safe way and you will have an active healthy future.

 

[jack412]

you have been flooded with info to digest and it may have seemed over whelming, there is a wealth of T1 knowledge for a lifetime from these guys, ask lots of questions

there is also an anon diabetic care line, if you feel like a chat with some one ....diabetes'org'uk has a lot of info too
http://www.diabetes.org.uk/careline

 

[jack412]

I missed that you were already on Lantus NovoRapid
I don't know if you have been on a course yet, but this may help a bit

Don't change dose without nurse approval
There is an online course for background and an idea to it. Free to join and register
http://www.bdec-e-learning.com/

Workbook 1
http://www.diabetesinscotland.org.uk/Publications/9225 Carbohydrate Counting.pdf
Workbook 2
http://www.diabetesinscotland.org.uk/Publications/9226 Carbohydrate Counting the Next Steps.pdf

Carb list
http://www.diabetesinscotland.org.uk/Publications/9227 Carbohydrate Tables A6.pdf

Diary
http://www.diabetesinscotland.org.uk/Publications/9228 Free Diary Portrait A4.pdf

Basal testing
http://www.diabetes-support.org.uk/info/?page_id=120

Sick day rules
http://www.diabetes-healthnet.ac.uk...flet_-_Sick_Day_Rules_for_Type_1_-_Nov_13.pdf
Sick day rules flowchart
http://www.leicestershirediabetes.org.uk/uploads//documents/Type1 Sick_day_rules_InsulinV3.pdf


A workbook with USA numbers, but has a good troubleshooting section
http://www.bd.com/us/diabetes/download/insulin_adjustment_workbook_complete.pdf

 

[Activeyoungwoman]

First of all, thank you for all your responses and your concern for a stranger.
However, I realized I probably need to explain my situation further to gain answers relevant to me. I am, as my name here suggests, a young and active woman. I exercise every day, in various forms but always at least one hour a day, and adding to that I also walk at least 5 kilometers and a few times a week bicycle 10 kilometers. I am in NO ways trying to become the society's version of "sexy/skinny" I just feel like I during this past month I've gained an extreme amount of excess weight which disturbs me in my life. It was a reaction to the diagnosis - I ate all sorts of junk food and just injected a lot of insulin at the same time. This has led to an extreme weight add-on. I'm now in the acceptance state of mind and (thanks to stuffing the past month) now I'm prepared to fully give up carbs and aim for a normal blood sugar level. BUT I firstly want to get rid of the excess weight, and since I know that I don't have time to increase my exercise into my normal life and that my current exercising simply maintains a weight (not losing weight) - I want to use my body's disease to actually become healthy again. Of course I'm going to change my diet, but that alone will not make me lose weight or at least not as quickly as I would wish. I do not wish to be more muscled/toned - I just want the fat to be shed.
To me it seems quite logic to want to use the disease to actually benefit my health. I'm definitely not going to do this any longer than a short period. I have read most everything one could read on diabetes, I can carbcount, I know what insulin does, I am living a healthy life, and I am aware of the increased risks I'd be putting myself through. I don't have any insulin production left at all, I've read and heard that most diabetes type 1s when diagnosed can still have some left which plays havoc with their control of glucose levels. But since I've gone such long time without diagnosis or insulin, doctors has realized I do not have any production left. My body is also accustomed to going a long period of time with very high levels - I can also go so high as 25-30 without having any symptoms at all I feel just fine. When diagnosed I had 40+ in glucose level and a hba1c on 20% and I was not dehydrated neither did I have DKA. I therefore believe my body is quite "capable" to deal with high glucose levels, although I don't think it would be if it was used to having normal glucose levels. This has led me to believe I need to do this as soon as possible, when my body is still accustomed to the high levels rather than normal. Furthermore, I want to make this period as short as possible since it's likely that it will increase risks for complications further down the road. But I really really want to get rid of the excess weight I've put on since overeating all this junk.
I'm eagerly awaiting further responses!

 

[jack412]

you have to have ketones to lose weight, it's a by-product of fat burning
you can get ketones from very low insulin/hi bg or very low carb/lo bg

ketogenic diet get ketones without any damage or risk of dka and you can run ketogenic at higher ketones,

https://www.google.com.au/#q=ketogenic+

get some blood ketostrips and a meter they work in. dr should give a script and urine ketostrips for back up, you will find they aren't accurate like blood ketostrips
Urine Ketostix don't measure all types of ketones produced by your body. Although there are 3 types of ketones (acetate, acetoacetate and beta-hydroxybutyrate), they only measure acetoacetate. Depending on how long you have been in ketosis, your body produces different types and amounts of ketones and you may not be able to detect acetoacetate when keto-adapted.

this may be why you didn't show ketones when you had BG 40, they used urine ketostips and you were keto adapted because of the length of time

 

[Ambersilva]

Words fail me. Why would anybody even consider risking a very unpleasant experience in the belief that it could provide a method of losing weight. You need the correct amount of insulin for your body and particularly your brain to function efficiently. As a type 1, I have learnt how to vary my insulin to match it to what I am eating and my energy requirements.

Help your body to settle into the new lifelong regimen without ridiculous thoughts about restricting insulin that could ultimately damage your body and intellect forever.

 

[jack412]

the other thing that hasn't been mentioned is that carbs can be almost addictive and for me was very hard to cut down
if you have a meal and then find yourself starving 2 hrs later, it could be the carbs, if you open a block of chocolate and eat it all in one sitting, it's carbs
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm

 

[jack412]

as per my signature, I started to eat a ketogenic low carb high fat diet, I lost 5kg the first month then I platoed for about a month since then lost another 5kg, but I'm not very strict on myself
I was 115kg and am now 105kg

this is a good site to read and there is a video to watch
http://www.dietdoctor.com/lchf

incase you thought you were the only one here, some I remember.
http://www.diabetes.co.uk/forum/threads/gaining-weight.56555/

http://www.diabetes.co.uk/forum/threads/in-pain.59209/

http://www.diabetes.co.uk/forum/threads/im-really-struggling.56420/

http://www.diabetes.co.uk/forum/threads/feeling-sad-lost-and-confused.59195/

http://www.diabetes.co.uk/forum/threads/just-got-diagnosed.53573/

http://www.diabetes.co.uk/forum/threads/having-a-bit-of-a-moany-fed-up-moment.63962/

 

[Loobles]

Please, please, please, as somebody who's struggled with eating for years, please don't even start going down this route. I have tears in my eyes here at the thought of your life ending up like mine, with intrusive distressing thoughts about food and weight loss every waking minute. I've sent you a message, please read it and understand that I can't emphasise enough that it's not a route you should go down. If you need to talk, I'm here and I'm a good listener. You're a beautiful, wonderful and unique woman, no matter what size you are x

 

[phoenix]

I know I said some of this in my first post but it needs repeating.
When you start insulin in the first place (especially if you have had low insulin levels for a period) or if you restart taking insulin, you will regain both the ability to use and store energy from food but also fluid you have lost (you were dehydrated, sorry it's a fact of life with hyperglycaemia; I wont' give a biochemistry lesson but it happens, why do you think you were needing to drink so much ?)

Sometimes the body takes time to readjust and get the fluid balance right. (just do the maths, it is extremely doubtful that 20kg can all have come from food, there are over 9000 calories in 1kg of fat )

You are only a month into this , bloat is temporary .
If you cut your injections , trying to use your condition as a 'magic bullet' that same bloat will happen again when you have to start using insulin again. You will not have gained anything but you will have risked DKA and also done some unseen damage to yourself through high blood glucose..

If you don't believe me, please read this forum post about bloating after restarting insulin . As the metabolism gets more deranged it can get worse each time as these women tell us ) .
http://www.wearediabetes.org/forum/thread.php?tid=37
or this one here note how she says she ended up in a cycle of losing weight through insulin omission, taking the insulin, seeing the 'bloat' and starting all over again.
http://diabulimiasos.weebly.com/my-story.html
It is a no win situation.

Please talk to your parents or your doctor , tell them how you feel about things
If you don't want to talk to them ,you could talk to young women who have done this to get a real view, they have a facebook page; links at bottom panel on right hand side.http://www.dwed.org.uk/
You are right in that you have had a reaction to getting diabetes. It is a big shock to all of us . I don't think that you are over it yet ..
Everyone writing on this thread has diabetes of one sort or another . We're not preaching just concerned.

 

[Loobles]

Everyone writing on this thread has diabetes of one sort or another . We're not preaching just concerned.

Same here, just concerned x

 

[Dillinger]

Hi,

I'm glad you have asked this and I know it is very difficult to come to terms with diabetes but the key thing that you need to take away from this is everyone, everyone on this thread has said 'don't do it'.

I would like to add to that too; don't do it!

When you have a bit more experience of this forum you will see that 100% consensus on pretty much anything is as rare as hen's teeth here.

I think that you are thinking in the right sort of area (insulin leads to weight gain, therefore you need to reduce insulin) but the diabulimia solution that you are considering is completely barking up the wrong tree. In fact it's not barking up the wrong tree it's jumping off the wrong cliff.

Diabulimia will mean very high blood sugar levels which can cause irreversible damage to pretty much every part of your body. It will also mean you are constantly at risk of DKA which is potentially fatal. It is not the route to go.

Consider as an alternative a low carb diet; your insulin requirements will be much reduced (you have to have insulin though) and it will help with your weight.

Your body has just undergone a huge metabolic trauma; if you pursue diabulimia in addition to that you will be giving it another sustained metabolic kicking.

You are a diabetic now and that of itself is a huge thing to get your head around; not taking insulin will not make you not diabetic it will make you a very sick possibly dead diabetic.

You are not alone, there are answers and there are, as you will have seen, many people who want to help and have access to some very good information. Now is the time to start getting to grips with this thing and you can move forward with your management of this condition and lead a full active life.

Best

Dillinger

 

[Loobles]

please include sources for your information and do consider explaining how you came to your expertise (are you perhaps a doctor? Etc).

I've already added to the discussion above, but I'd like to add, having just seen the quoted comment above, I am an ex-nurse and worked in paediatrics for a few years. I have personally resuscitated and been with diabetic teenagers who have died because of DKA. And yes, that is supposed to alarm you, because I can assure you that from my point of view, that was not a nice experience for anyone.

 

[Dillinger]

So, @Activeyoungwoman what are your thoughts on this?

Best

Dillinger

 

[jack412]

@Activeyoungwoman just posting to ask, how are you going? I hope you are well and found that reduced cabs topped up will healthy fats/oils, will let you have the minimum insulin and lose the weight you wish to.

 

[Loobles]

@Activeyoungwoman just posting to ask, how are you going? I hope you are well and found that reduced cabs topped up will healthy fats/oils, will let you have the minimum insulin and lose the weight you wish to.

I was wondering about this, I sent her a PM too, but she kind of disappeared. Not sure if I frightened her away