Could Your Diabetic Teen Have Diabulemia?
A study out of the Joslin Diabetes Center in Boston states that 30 percent of women with Type 1 diabetes have restricted their use of insulin to lose weight at some point in their lives. This withholding of insulin to promote weight loss has recently been labeled diabulemia. Another study featured in Diabetes Spectrum, a publication of the American Diabetes Association, states that adolescent women with Type 1 diabetes are at more than twice the risk than their peers for an eating disorder. These recent studies highlight the fact that teen women with this disease are at risk for serious health problems – not just because of their condition, but because of the lengths they will go to to control their weight.
The Risks of Restricting Insulin for Weight Loss
The lead investigator of the study from the Joslin Diabetes Center, Ann E. Goebel-Fabbri, Ph.D., notes that there are many serious consequences of restricting insulin dosing for weight loss. These consequences include:
- Higher A1C levels
- Higher risk of developing infections
- More frequent episodes of diabetic ketoacidosis
- More frequent hospital and emergency room visits
- Higher rates and earlier onset of diabetes complications - nerve damage, eye disease, kidney disease and possible heart disease
The study determined that a woman who restricted her insulin for weight loss had an average life span of 45 years. Women who did not restrict their insulin dosages had an average life span of 58 years. This tactic for quick weight loss seems to cut a woman’s life expectancy down by approximately 13 years – dramatic consequences for what some women see as a harmless way to lose weight.
How Can I Tell if My Teen Daughter is Restricting Her Insulin to Lose Weight?
Goebel-Fabbri states that there are some tell-tale signs that are present when someone is restricting insulin for weight loss purposes. These signs include:
- Weight loss despite eating more food
- Low energy level or lethargy
- Increased urination
- Increased blood sugar levels or increased A1C levels
- Repeated problems with diabetic ketoacidosis
- Extreme concerns about weight and body image
- Unusual patterns of intense exercise
- Amenorrhea (skipping menstrual periods)
Where to Go For Help
If you suspect that your teen is restricting her insulin for weight loss purposes, it is important to get help right away. Discuss your concerns with your teen. She might want to talk about how she feels and having an open and honest conversation about the situation can be a positive first step towards recovery.
If her blood sugar levels are out of control, or if she eats excessively and continues to lose weight, she may still try to deny her insulin restriction. It is important to get the specialist that manages her diabetes involved when you see the signs of poorly-controlled diabetes.
Whether or not your teen admits to practicing “diabulemia”, it is important to contact the endocrinologist or other specialist if you see any of the warning signs of insulin restriction. You may also ask to have a nutritionist, exercise specialist or a psychologist who deals with eating disorders consulted. Eating disorders can be complicated to treat and life threatening if ignored. To protect your teen’s health, enlist the help of professionals to assist your child with this difficult struggle.
Sources: Daneman MB, BCh, FRCPC, Denis and Rodin MD, FRCPC, Gary, Jones PhD, Jennifer, Colton MD, Patricia, Rydall MSc, Anne, Maharaj PhD, Sherry and Olmsted PhD, Marion. Eating Disorders in Adolescent Girls and Young Adult Women With Type 1 Diabetes.”Diabetes Spectrum2002 15:83-105. 06 August 2008. Eating Disorders/"Diabulimia" in Type 1 Diabetes. Goebel-Fabbri, Ann, Ph.D. 06 August 2008. http://www.joslin.org/managing_your_diabetes_4039.asp Joslin Study Finds Restricting Insulin Doses Increases Mortality Risk. Joslin Diabetes Center. 06 August 2008. http://www.joslin.org/1083_4281.asp
