Saturday, 13 April 2013

Diabulimia

I have had a few people ask me about diabulimia. Interesingly enough, I have just completed a project about this topic, so I'm going to try to address it here. Because I do not have this problem, I am putting this on the spot now: I am not an expert about this topic. I am only addressing it here because people have asked me to do so. (See http://journals.lww.com/dccnjournal/Abstract/2009/07000/Diabulimia)

Diabulimia comes from the words 'diabetes' and 'bulimia', but it basically refers to people with type 1 diabetes (autoimmune) who suffer from ED as well. They misuse their insulin by giving too little (or none at all) in order to lose weight.

I empathize with people with this condition because it is really hard. Diabetes is a complciated condition that NEEDS to be treated, espeically type 1. These people NEED insulin to live because without it, their body cannot get enough nutrition. So, not using their insulin really does make them lose weight, but they also become very sick. Withholding insulin means that theit bodies cannot use glucose for energy, so it begins to break down fats. This leads to ketoacidosis, a lfie-threatening condition that needs immediate medical attention.

I know that having diabulimia is tough - ED alone is hard, even without diabetes. Recovery from this is necessary because again, both conditions are life-threatening. You need good, medical care. Diabetes is totally manageable with a good healthcare team and plan. While ED will not want you to use the insulin, you need to know that you HAVE to use it. It is your medicine. You might gain some weight, but it will stop when your body is healthy. If you are following your treatment and what your healthcare providers say, they will not make you fat. It IS hard having to use insulin when you feel that every inch of you does not want it. Having an insulin pump is hard beccause you feel so angry that you need to use it. But without insulin, you can die.

ED makes life so hard, doesn't he? He will try to hurt these people with diabetes, telling them not to use insulin so that they can lose weight. What he does not say is that this will kill them. He fills their heads with thoughts of gaining weight but he does not tell them that if they follow a meal plan, they will not get fat. I know many people with type 1 diabetes who are healthy and not fat, nor thin. It is POSSIBLE. You just need to follow your treatment plan - whatever that may be. Maybe you need to follow a meal plan, take insulin, or carb count. It seems tedious, I know. But it is what your body needs.

If you suffer from diabulimia, know that you are not alone. There are many people who have the same condition, but because the DSM criteria does not include it, it can be hard getting treatment. But you DESERVE help. I know that getting into a treatment centre is difficult (if not impossible) beucase diabulimia is not considered a true 'eating disorder'. But in my eyes, it IS. And you deserve help. If you cannot get into an ED program, get to the hospital and tell them that you need help. Get to yor doctor and dietitian and get a plan to follow. I do not care what anyone says - any ED, big or small, strong or weak - is a mental illness. Anyone who suffers from any type of ED needs help because they cannot do it alone. They deserve to get treatment. No one can tell you that you do not deserve help. Recovery is possible. But you need to accept that you need treatment, and that for now, insulin and food really are your medicine. They are necesary. ED will not like this. But you need to tell ED to SHUT UP because you deserve to LIVE and be HEALTHY.

Stupid ED. He is such a loser. He tries to make victims fall in any way possible. But we are stronger. You might not feel strong, but know that there are always people here to support you.

23 comments:

  1. Sounds like ,more serious than ED.
    My heart with you guys

    Helena

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  2. My dad has type 2 diabetes and my son has type 1 and taking insulin.
    Doctors advise to both to eat 3 meals and 3 snacks .
    Both are doing fabuolusly thank goddness.
    I think haveing ED is the problem not diabetes in diabulemia

    Sorina

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  3. Excellent post even though you said you have no experience .
    I feel sorry for those who have this disease.
    Question Marina
    How you can change victims mind to believe doctors advise and ignore ED commands?
    For me (because I am not victim of ED) is easy ,ED advise take you to death or poor health and brain damage.
    Doctors advise may be tough to follow but makes you healthy and think and feel better.
    Why ED victim listen to ED and not families and doctors?
    Question worth million dollars!!!

    Jack
    Political science student

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  4. Very articulate writer.
    WOW MARINA


    Mays

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  5. I am happy to hear that you do support ,motivate and encouragge every one ,not only those with ED or mental health.You also understand diabetes.
    I agree Diabulemia is worse than ED but both deadly and misleading and skewing the victim's thinking.

    Shishgeri

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  6. I can not beleive it that somebody has diabetes and is not taking their insulin!!
    Do not they know that not taking insulin ,means not losing wieght but losing life, or a at least brain and heart damage and the consequences to follow


    Gustavo

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  7. In just one page ,you are able to summarize the disease and give a n advise and honest opinion.
    I pray God bless you and bless those who suffer them dublomia.


    Sunday Priest

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  8. Excellent post Marina .
    I think people with Diabulemia better take it seriously and make the necssary change in their behaviour,admit the problem,seek help before too late.
    I will discuss this in my next group discussion in my out patient program and see if I can bring some info.


    Anne

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  9. I like you article. It is a double edged sword though a lot of people with type 1 range from slightly overweight to obese. It is a side effect of intensive insulin therapy.

    I know people who are both thin and heavy with type 1. You can never tell how someone’s control is from their size. Like you can have very tight excellent blood sugar control and be obese.

    And someone who skips insulin all the time to lose weight can look average – like not too skinny. But really they are dying on the inside.

    I think one of the biggest problem is that the word diabetes is used without taking a minute to distinguish type 1 or type 2, and the comment is usually related to how diabetes is caused by lifestyle and weight

    Jamie

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  10. Marina
    Look I am 76 and have type 2 and I am controlling my sugar with insulin and metformin.I eat 3 meals and 3 snacks and my weight has been same for last 50 years .
    I agree with you ED is the burden for this disease not diabetes


    It is not too late to learn something new
    Thanks Marina

    Sam Ibrahim
    Burnhamthorpe ,Mississauga

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    Replies
    1. good point, but having an ED and diabetes 1 is like twice as deadly

      Tim

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    2. Diabetes is not that deadly(look I am 76 and I have it for years and I enjoy good health)
      ED is more deadly than any other disease especilly victims not willing to get or ask for help.

      Sam

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    3. With type 1 diabetes a simple infection can put you in ICU with ketoacidosis. I have had type 1 diabetes since i was 7, i am on an insulin pump and need insulin infused into me constantly to control my blood sugar.

      Once when i was 12 my infusion set got clogged, in the morning my mother found i was in a coma from ketoacidosis because my infusion set was occluded.

      I was in the pediatric ICU for a week and my parents were told i might die.

      Not to mention - 1 in 20 type 1 diabetics actually die of hypoglycaemia

      http://www2.jdrf.org/site/DocServer/JDRF_FDA_Ad_Nov_2011.pdf

      i am sure that marina can clarify but type 1 and type 2 diabetes are two different conditions.

      I need to be constantly vigilant with type 1. I test my sugar ten times a day. I weigh and measure all my food. I wake up at 2am every single night to test my blood sugar and check my infusion set

      Also, type 2 can be reversed with radical diet changes. Such as low carb diets

      Jamie

      Delete
  11. I am orginally from Iraq and i am Kurdish.
    I had long history of anorexia and I was treated when I came to Canada 12 years ago.
    Now I am married and teaching high school.
    To say that ED affecting only Caucasian ,is not true

    Fatimah

    ReplyDelete
    Replies
    1. I agree with Fatima
      If you recall your first post I left a comment about myself.
      I am originally from India and I had severe loss of appetite and lost weight and my family took me to many doctors but no help till I came to Canada and I was diagonsed and treated in Toronto.
      I recovred and got married and I have 2 children and I am reading a lot to protect my children and I do not want them to suffer as I suffred.
      I feel sorry for Angela who blames her white genes for the ED
      Marina you wrote before a psot titled ED does not dicriminate and I agree completely

      Delete
  12. Hello everyone! I just want to add some things to this post/comments. While I am thankful for everyone's comments and insight, I want to say a few things:
    1) I am not your doctor or an expert. But I CAN provide medical information of diabetes because of my research. FIRST, type 1 diabetes is autoimmune. Type 2 is not. However, both are caused by changes in the body that is still not well understood. Someone with type 1 diabetes can be over or underweight. Same with type 2. Just because tghe news says that type 2 is caued by lifestyle does NOT MEAN THAT EVERYONE WITH TYPE 2 IS OVERWEIGHT OR IT IS THEIR FAULT. Science still needs to learn more about diabetes.

    2) type 1 and 2 are both serious problems. Both can lead to ketoacidosis. Both need to be managed by doctors and dietitians. Both conditions require careful monitoring of blood glucose and insulin (more so insulin in type 1, but type 2 might need it as well).

    3) in terms of ED, it can strike anyone, as I have said many times. I am a nurse and it hit me. No discrimination. I cannot say which is worse, ED or diabetes - because both are serious and it all depends on the patient. But both are manageable and both can be treated successfully. Anyone who is struggling with diabetes needs support, and the same with ED.

    4) I am, in no way, suggesting that people with diabulimia cannot recover without help. They need help, just like people with ED alone do. The point of this post was to open our eyes to realize that ED can strike anyone, that it is a common and complicated problem, etc. If you have diabtes (type one or two) and ED, you need help. Just like someone with ED alone does. Just like someone with diabetes alone does. That is why we have doctors, nurses, and healthcare. Any medical condition deserves help.

    5) Hypoglycemia can happen with anyone. I nearly passed out because of hyploglemia one day (I will post on that soon!). Someone with diabetes might be more prone to this because if they use insulin and are not careful with eating, it can occur faster and without warning. Someone with ED can experience hypogelycemia if they do not eat well. Somsone without ED OR diabetes can experience low sugar levels if they do not eat well.

    I hope that helps to clarify! It is nice to have everyone on the same page...

    ReplyDelete
  13. Thanks for the clarification Marina.
    I guess regular eating is the main goal to protect against hypoglycemia in both ED and Diabetes especailly in Diabulemia who need to take their insulin regaulrly also.
    I am gald Jaime is checking her blood sugar regulrly but I hope this is not OCD

    Penny

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  14. This post and comment contain lots of info that We need to be aware off whether having ED or diabetes or not.
    Thank you


    Zophara

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  15. My endocrinologist prescribes me 11 test strips per day because I have hypoglycaemia unawareness and because I went into DKA from a bad infusion set. I think 10 times a day is normal with a pump, and 4 times a day is normal with injections. You don’t have to eat on a schedule with the newer insulins like lantus or on a pump
    I would really encourage you to shadow a paediatric endocrinologist or work at a diabetes camp for experience. You can learn a lot about type 1 diabetes. The biggest risk with a pump is a bad infusion set. With an occluded infusion set you can go into DKA very quickly
    Jamie

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    Replies
    1. Jamie I pray for you as well as all ill people.Hypoglycemia unawareness is terrible and so you really doing well testing 10times daily to make sure.Do you have Diabulemia or only Type 1 daibetes.


      Sally

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    2. I am type 1 diabetic. I am on a continuous infusion of insulin with an insulin pump.

      I never skipped a dose, so no diabulimia.

      I have gone through periods of eating very little because I wanted to lose weight, I let my endocrinologist know.

      I also see a dietician, but she specializes in childhood diabetes not ED.

      I see a pediatric diabetes team, although I just turned 18. I will be switching to an adult team around Sept

      Jamie

      Delete
  16. I like this post and all the comments.
    This is an example of group venting,therapy in a constructive supportive compassionate way.

    Clorado

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  17. What an excellent source of information,support,good honest responsible advise
    I give you an standing ovation Marina

    Oswaldo

    ReplyDelete

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