SIGNS & ED-DMT1 & TALKING TO SYMPTOMS DIABULIMIA A LOVED ONE

An individual with type 1 is Studies have shown that 36% of people There’s no script for talking to a loved one 2.5 times more likely to develop an with purposefully omit or struggling with diabulimia, but there are certain than one without. restrict their for . As with remarks that can do more harm than good. Insulin restriction is a common purging other eating disorders, however, diabulimia is People with diabetes are constantly told what’s symptom and is often referred to as motivated by more than a desire to be thin. best for them. Even when a friend or family diabulimia. The member believes they’re providing gentle advice, include: For a person with type 1 diabetes, an eating their words can come across as criticism or yet • Changes in eating habits (typically disorder can serve as a means of taking back another lecture. eating more but still losing weight). control. Having been lectured for years about the importance of control—keeping A1Cs • Rapid weight loss or weight gain. It’s normal for family and friends, plagued with in range, watching food intake – one may • Blood glucose values well above feelings of distress, guilt, and confusion to feel experience a feeling of control by rejecting target range. like they can fix the situation. But while outsiders those exact dictums. • Low self-esteem or preoccupation recognize diabulimia for the serious problem that with , weight or food Without enough insulin, sugar builds up in it is, those struggling with the disease often feel intake. the blood and starts to cause damage to the differently. An eating disorder can be a security • Frequent urination, excessive thirst, body, creating both short-term and long-term blanket, a best friend, a source of comfort. or high blood-sugar levels. medical problems. Patients with diabulimia • Low energy, , shakiness, routinely suffer from anxiety and depression. irritability, confusion, anxiety or This diminished quality of life are hallmarks of “The term ‘diabulimia’ is not a even fainting. the disease and prove just as painful as the • Purging behaviors (such as physical complications. clinical diagnosis. However, it has vomiting, excessive exercise or the provided people who struggle with use of laxatives). The terms ED-DMT1 and Diabulimia are only disordered eating in the context of • Discomfort with eating or taking a few years old, but despite this step toward type 1 diabetes a way of discussing insulin in front of other people. legitimization, the disorder is not officially and describing their struggle. Eating recognized as a medical or psychiatric • Hoarding food. disorders and diabetes present • Unwillingness to follow through condition. While health professionals are serious health problems. It raises with medical appointments. increasingly aware of diabulimia, little is • Recurrent diabetic known about effective treatments. This needs the risk of developing diabetes to change. (DKA). complications early in their disease duration, especially eye disease. It also raises the acute risk of , a potentially fatal “The cognitive effects of low body weight in a person with an medical crisis. The powerfully good eating disorder are well known, but prolonged elevated blood news is that we know this uniquely glucose itself heightens the lack of concentration, increases dangerous eating disorder is inflexible thinking and compulsive behaviors, and mimics treatable and that people can and depression.” do recover.” Marcia Meier, RN, CDE Dr. Ann Goebel-Fabbri OUR MISSION

We Are Diabetes provides support to people with type 1 diabetes who are seeking help in their struggle with diabulimia (ED-DMT1). We have three primary aims: to promote awareness of ED-DMT1, to support those who are suffering, and to advocate for more “The interaction of type 1 support from the healthcare industry. diabetes and an eating disorder often has the result of poor It’s hard enough to handle the metabolic control and major requirements of living with a chronic medical complications such illness. A person with type 1 diabetes as gastroparesis, neuropathy, who also suffers from an eating disorder nephropathy, and retinopathy. faces the additional challenge of finding Our current research suggests suitable treatment despite widespread that over 36% of ED- DMT1 ignorance and judgement surrounding patients have intentionally their condition. Patients who are reduced or omitted insulin on seeking recovery need support from a a regular basis to influence safe and knowledgeable community of weight. Due to the complexity others who have been there - We Are of the dual diagnosis of type 1 Diabetes provides such a community. diabetes and an eating disorder, An eating disorder affects more than a multidisciplinary team who just one person. Family and loved ones communicate on a regular basis often suffer in silence as they watch is essential for recovery.” someone they love hurt themselves. We Are Diabetes strives not only to support Marcia Meier, RN, CDE the individual suffering from diabulimia, but to aid the people close to them in learning how to better support the recovery process.

WE ARE DIABETES PO BOX 16263 MINNEAPOLIS, MN. 55416 WEAREDIABETES.ORG