Diabulimia is a form of eating disorder in which a person with diabetes  reduces insulin intake in order to lose weight. Diabulimia is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), yet it can cause major medical complications.

Overview

Diabulimia is a term that combines the words diabetes and bulimia. Eating Problem-Diabetes Mellitus Sort 1 (ED-DMT1) is a term used by some medical experts to refer to any type of eating disorder that is comorbid with type 1 diabetes. Adolescents with type 1 diabetes account for between 11.5 percent and 27.5 percent of those who satisfy the diagnostic criteria for an eating disorder, the most frequent of which is bulimia nervosa or binge eating disorder. Diabulimia requires professional therapy because it is a mental condition. If you or someone you care about is exhibiting symptoms of diabulimia, seek medical, nutritional, and psychological support.

Diabulimia

Symptoms of Diabulimia

Because an individual requires insulin, physical indicators of diabulimia will definitely appear, as will symptoms of insulin deficiency, such as:
• Uncontrollable thirst
• Urination that is excessive
• Weakness/Fatigue
• Unprecedented blood glucose fluctuations
• Diabetic ketoacidosis only gets better in the hospital.
• Uneven heart rate.
• Nausea/vomiting
• Rapid weight loss is possible.
• Infections of the bladder.
• Vision that is hazy.
• Skin and hair that is dry and fragile.

Diabulimia behavioral indications may be more visible to a loved one because they do not require testing and will indicate that anything bad is happening. These are some of the warning signs:

• Having worry or dread of gaining weight.
• Those with petite or slim bodies are praised.
• Refusal to let others see injections.
• Discussing the effect of insulin on weight.
• Having low self-esteem and/or a negative body image.
• Isolating oneself from the rest of the world.
• Increased depression and/or anxiety symptoms or expression.
• Skipping doctor’s appointments.

Causes of Diabulimia

Diabulimia is an eating disorder linked to type 1 diabetes and is caused by a combination of genetic, biochemical, psychological, and societal variables, as do all eating disorders. The following are some biological factors that may predispose someone to diabulimia:
• Having diabetes type 1
• There is a history of eating disorders in your family.
• Being a woman.
• A diagnosis of anxiety.

Risk factors of Diabulimia

Diabulimia occurs when you purposefully avoid taking the insulin required to manage your type 1 diabetes in order to lose weight. Your body cannot produce insulin if you have type 1 diabetes. Because you can’t use sugar for energy, your blood sugar levels rise, and excess sugar is excreted in your urine.
You can also produce ketones as a source of energy if you don’t have enough insulin, which can lead to anorexia and weight loss. Diabetic ketoacidosis, which can lead to coma or death, can occur as a result of this.

Complications of Diabulimia

Diabulimia complications are a mixture of those that come with diabetes and eating disorders:
• Higher blood sugar levels
• Sugar/glucose in the urine
• Confusion
• Lack of fluids /dehydration
• Muscle loss (atrophy)
• Diabetic ketoacidosis
• Higher levels of cholesterol
• Bacterial infections of the skin
• Yeast infections
• Skipped or disturbed periods
• Staph infections
• Damage to the blood vessels of eyes (retinopathy)
• Numbness in hands and feet due to nerve damage
• Peripheral arterial disease (PAD)
• Thicker / harder arterial walls (atherosclerosis)
• Liver disease
• Low sodium and potassium levels
• Coma
• Stroke
• Death

Prevention of Diabulimia

Diabulimia requires professional therapy because it is a mental condition. If you or someone you care about is exhibiting symptoms of diabulimia, seek medical, nutritional, and psychological support from professionals such as:
• Diabetes counselors
• Social workers
• Endocrinologists
• Nutritionists who specialize in eating disorders or diabetes
• Nurses
• Counselors/psychologists

Diagnosis of Diabulimia

Diabulimia is diagnosed when a diabetic has hyperglycemia, an elevated HbA1c despite insulin treatment, weight loss despite increased food consumption, recurrent diabetic ketoacidosis, and typical diabetes symptoms such as excessive appetite, urine, and thirst.

Treatment of Diabulimia

Diabulimia treatment is not a quick remedy. Changing behavior patterns and learning to control triggers might take a variety of ways and a lot of hard effort.
• Counseling can be really beneficial.
• You can try cognitive behavior therapy (CBT), which focuses on changing your thoughts in order to improve your behavior.
• Group therapy, which provides support from other diabulimia sufferers.
• Family-based therapy (FBT) is a type of therapy that involves the entire family. It can be a useful tool for parents who have a teen who is suffering from the disease.