Diabulimia: How are diabetes and eating disorders related?

Insulin therapy is the cornerstone of any treatment plan for type 1 diabetes. Skipping or shortchanging doses of insulin to prevent weight gain — a common side effect of insulin therapy — is a dangerous practice sometimes referred to as diabulimia. Although diabulimia can affect anyone who has type 1 diabetes, adolescent girls are most likely to manipulate insulin doses to lose weight. In fact, according to the American Diabetes Association, an estimated 30 percent to 40 percent of female teens and young adults who have diabetes skip or alter insulin doses to control their weight.

Diabulimia isn't a recognized medical condition. In fact, the term has only gained popularity recently. But like all eating disorders, diabulimia has serious consequences.

People who have type 1 diabetes need insulin therapy to survive. Without enough insulin, sugar (glucose) can't enter the cells. This causes the person's blood sugar level to rise. Eventually, insufficient insulin can lead to diabetic ketoacidosis — a life-threatening condition in which the body breaks down fat and protein for energy. High blood sugar also increases the risk of long-term diabetes complications, including heart and blood vessel disease, nerve damage and kidney damage.

Warning signs of diabulimia may include:

• Weight loss
• Excessive thirst
• Frequent urination
• Low energy
• Nausea
• Fruity-scented breath (a sign of diabetic ketoacidosis)
• Decreased attention to blood sugar monitoring or insulin doses
• Loss of blood sugar control

Often, diabulimia is suspected by a friend or parent before the person who has diabetes admits that anything is wrong. If you have diabulimia or you suspect that a loved one has diabulimia, seek help immediately. Ideally, treatment will involve specialists in both eating disorders and diabetes. Early intervention may save a life.