Heard of diabulimia?

We’re all familiar with the term bulimia. But how many of us are aware of diabulimia? Chances are, hardly any of us. This condition though not very common amongst the population has far more harmful effects on health. And with India being called the diabetes capital of the world, it’s time we became aware of diabulimia. Experts give their take...

What is it?

Over the years, most type 1 diabetes patients realise that they put on weight when their blood sugar is well controlled and they lose weight when the control goes haywire. This happens because insulin is an anabolic hormone and it helps fat deposition and weight gain. Hence, some of them, especially young college girls who are figure conscious tend to skip their insulin doses or often under dose themselves so as to remain thin. This is called diabulimia, explains Dr Pradeep Gadge, diabetologist, Dr Gadge’s Diabetes Care Centre. 

He sees such type 1 patients, at least one in three months and recounts the case of a patient, “I remember a model who had type 1 diabetes who would visit my clinic. She started putting on weight after my treatment as her sugars got better controlled. So she purposely started under dosing herself to maintain her weight. When I objected to this, she said ‘I will lose my contracts if my weight goes up’. Finally, in spite of multiple attempts to convince her that this behaviour will cause complications in future, she refused to listen and stopped coming.”

Lack of awareness

“There are many aspects of eating disorders that are still uncovered. Diabulimia is a relatively new form and the link between type 1 diabetes and eating disorder is not yet recognised as a medical or psychiatric disorder. As a result, it is greatly under-diagnosed and left untreated,” explains Dr Abhay Vispute, diabetologist and physician, SRV Hospital, adding that the first step is understanding causes and symptoms. Numerous studies conclude that women with type 1 diabetes are twice as likely to be diagnosed with eating disorders compared to their non-diabetic peers. Also, type 1 diabetic men can and do suffer from eating disorders but they have lesser risk as they are less required to have a particular body type.

Causes

There are many factors that can contribute to the increased risk of diabulimia, says Dr Vispute. The necessary emphasis on food and dietary restraint association with the management of type 1 diabetes can create unhealthy forms of food, numbers and control. The emotional effects of having to manage a chronic medical condition such as type 1 diabetes can also play a vital role. Depression, anxiety and poor body image are common with the dual diagnosis of diabulimia.

Harmful effects

“Of course, this disease comes with many unwanted body changes. It lacks out insulin and if the patient continuously avoids taking injection, it will lead to death. The patient might suffer from high level of glucose, dehydration, muscle loss, menstruation disruption. This disease is mostly seen in teenagers, they tend to get more infections due to decreased immunity in the body,” warns Dr Vispute.
 
Dr Gadge points out that the most dangerous effect can be diabetic ketoacidosis (where the patient can go into a coma and even die). Other short term complications can include electrolyte imbalance, tiredness, fatigue, visual disturbances, increased chances of infection, memory loss, depression, etc. Long term complications could be diabetic kidney disease (very common in type 1 diabetics), heart disease, retinopathy, neuropathy, etc.