Write A Food And Feelings Diary
Keeping a food and feelings diary can be helpful for understanding some of your eating patterns and emotions linked with food.
You can download My Food and Mood Diary .
This is a great way to track what food youve eaten and the effect it could be having on your mood and your diabetes.
Think about bringing the diary to your next consultation . They wont judge you for anything you write down and it will really help them understand how youre feeling. Try to be as honest as possible the diary is there to help you.
Diabulimia An Eating Disorder Unique To People With Type 1 Diabetes
The term diabulimia is most commonly seen in young women with type 1 diabetes who withhold or restrict insulin for the purpose of weight loss. Without insulin, blood glucose levels will increase significantly as well as the risk of diabetic ketoacidosis, a potentially life-threatening condition. Speak to your doctor or someone from the diabetes healthcare team if you suspect that you or someone you know may be suffering from diabulimia.
What Types Of Eating Disorders Are Associated With Diabetes
There are two main types of eating disorders associated with diabetes:
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Talk To Other People With Diabetes
Youre not alone. You can chat anonymously on our online forum or go to a support group in person. Or follow us on social media to be part of our online communities and read what others are posting.
And if youre a friend or family member of someone with diabetes and worried theyre developing an eating problem, show them this information and suggest they read our stories from Lynsey and Lucinda. It might help them realise theyre not alone.
Know The Signs And Symptoms Of Dka And Insulin Edema
People with type 1 diabetes must learn the signs and symptoms of DKA which include excessive thirst, frequent urination, nausea and vomiting, confusion, fruity breath, and weakness or fatigue and when to seek treatment if necessary. In addition, its essential that they know that people with ED-DMT1 may retain fluid as they begin to lower their blood glucose levels. This is sometimes referred to as insulin edema and can result in rapid weight gain. According to Dr. Ann Goebel-Fabbri, author of Prevention and Recovery From Eating Disorders in Type 1 Diabetes, People with diabetes deserve to understand that it is fluid and not fat they are gaining and that the situation will improve over time. People will often say that they have experienced this type of weight gain in the past and went right back to their eating disorder out of fear.
In treating ED-DMT1, blood glucose levels should be lowered gradually over a period of months. This may help reduce the severity or even presence of edema. It will also help prevent false lows, or having the symptoms of hypoglycemia without being truly low. Going slowly may also feel less overwhelming to the person being treated.
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Body Image And Adolescence
People construct their identity in adolescence. How others perceive them and the desire to please become crucial issues. Adolescence is a time of life when many children have problems with body image. According to data from the Québec Health Survey of High School Students 2010-2011, approximately one in two high school students is satisfied with his/her appearance.
Dissatisfaction with body can lead to unhealthy behaviours. Among youth with diabetes, restricting food intake, or altering their diabetes treatment for the purpose of losing weight, can disrupt their blood sugar control and cause microvascular complications.
What Are The Risk Factors Of Developing An Eating Disorder With Type 1 Diabetes
Certain aspects of diabetes can trigger or contribute to maintaining one of these disorders.For example, starting a diet to treat one’s diabetes can be a trigger, the management of the disease requires quantifying the intake of carbohydrates and controlling one’s diet, if the person is psychologically vulnerable, he or she may be predisposed to develop an eating disorder.
It has also been found that most people newly diagnosed with type 1 diabetes gain weight when they start treatment. In addition, insulin is a hormone that can promote the storage of body fat in a sedentary person and, on the contrary, promote the development of muscle mass in a physically active person, which can result in weight gain.The psychological impact of this chronic condition should also be taken into account.
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Why Are Type 1 Diabetes And Eating Disorders Related
People with diabetes are more likely to develop eating disorders than other people. In T1D, the lack of insulin has a huge influence on weight loss, which can lead to poor adherence to treatment. Some people limit their treatment intake in order to lose weight, risking serious complications such as blindness or amputation. This phenomenon is particularly frequent in teenagers.The origin of this behavior is often linked to the fact that insulin injections allow the sugar to enter body cells for their energy needs and the excess of sugar is stored as fat. The main risk is that, without insulin, the excess of sugar will remain in the blood and damage small vessels, like those located in the eyes, kidneys and body extremities.
The aim of such unhealthy behavior is to control weight by making oneself vomit, using laxatives or diuretics, following very restrictive diets, having periods of fasting, etc.The prevalence of anorexia nervosa in patients with T1D is comparable to that in the general population. On the other hand, that of bulimia seems to be higher. This is called diabulimia.
Implications Of Disordered Eating For People With Diabetes
Eating disorders are associated with serious medical risks, including increased mortality a recent meta-analysis reported mortality rates of 5.1 for anorexia nervosa, 1.7 for bulimia nervosa, and 3.3 for eating disorder, not otherwise specified . In addition, even well-controlled diabetes puts stress on the body’s organs, and research demonstrates that microvascular complications begin at a younger age in people with diabetes than those without diabetes . Engaging in disordered eating patterns or insulin manipulation further stresses the body, and insulin restriction has been shown to increase mortality risk . The presence of eating disorders has also been correlated with higher levels of hemoglobin A1C levels in adolescents, indicating poorer glycemic control . In a recent meta-analysis, there was a medium effect size for disordered eating behavior and eating disorders on glycemic control . These findings emphasize the increased risk of disordered eating behaviors for individuals with diabetes, exacerbated by poor glycemic control .
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Support For Those With T1d And An Eating Disorder
Finding providers who are willing to learn can be very difficult. The culture of non-compliancy is still alive and well in the world of diabetes care, and this is a major deterrent for people living with this deadly dual diagnosis from getting the help they need, says Asha Brown, executive director of We Are Diabetes , a non-profit organization devoted to providing support, education, guidance and hope to people living with T1D who struggle with disordered eating behaviors. According to Brown, Judging and shaming a person with type 1 diabetes about the risks of their behaviors when theyre struggling with food is only going to make a catastrophic situation worse. She founded WAD after navigating her own eating disorder recovery.
Services offered by We Are Diabetes include referrals to credible providers and treatment centers, and support for both individuals who are struggling as well as their families and loved ones. WAD offers a unique mentorship program and resources designed specifically for people with T1D and eating disorders, as well as education for healthcare professionals.
Diabetes Technology/treatment And Eating Disorders
While advances in diabetes technology, such as continuous glucose monitoring and insulin pumps, provide greater flexibility, clinical observation suggests that they also have potential for misuse by individuals with body dissatisfaction. For example, pumps allow easy titration of insulin doses and may enable individuals to keep blood sugars high. Similarly, CGM provides constant glucose data, so individuals may believe they can more “safely” keep blood glucose elevated. Data presented in CGMs around mealtimes may cause individuals to restrict food intake to prevent blood glucose excursions. For adolescents, there may be less parental involvement/knowledge of diabetes management with pump therapy, allowing for more privacy and freedom to alter insulin doses. Further, food databases and focus on carbohydrate intake when using insulin pumps/CGMs may cause individuals to be overly aware of nutritional aspects of food and restrict or obsess about food intake. Finally, patients may ask for the hormone amylin , a medication prescribed to reduce postprandial hyperglycemia. A known side effect of amylin is reduced appetite, and it could therefore be misused/abused for weight loss. Thus, providers need to be aware of the risks for misuse of diabetes technology and medications in individuals seeking to lose weight.
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What Are The Psychological Risks Involved
It can be common for people with T1DE may also experience other conditions such as depression, anxiety and diabetes stress. Research has also shown that some people with type 1 diabetes may respond less positively to conventional eating disorder treatment .
Treatment adapted for people with eating disorders living type 1 diabetes is still in the early stages of development. However, it has been agreed that people who deliver treatment for T1DE should ideally have knowledge and understanding in treating both eating disorders and type 1 diabetes.
The Physical Symptoms And Consequences Of Diabulimia
Diabulimia means very high blood sugars. As a result, the immediate physical symptoms of diabulimia are essentially the same as the symptoms of acute and chronic hyperglycemia, including the following:
- Increased thirst
- Irritability and other mood changes
- Fatigue, weakness, and brain fog
- Blurred vision
- Rampant yeast infections
Doctors or parents sometimes initially detect diabulimia when they notice that a patients A1C has spiked upward with no apparent explanation.
Diabulimia can easily progress to diabetic ketoacidosis , which can lead to coma or death. DKA requires immediate medical treatment.
All of those short-term symptoms just scratch the surface of the amount of physical damage endured by the body during periods of highly elevated blood sugars. Uncontrolled blood sugars hugely accelerate the many long-term complications of diabetes, including kidney disease, eye damage, neuropathy, and the development of cardiovascular disease. Patients with diabulimia may experience the rapid early onset of conditions that would otherwise have taken many years to develop.
Asha Brown, who conquered her own diabulimia to become an advocate, once relayed a story about a client she was helping:
Most people with diabulimia alternate between periods of using more and less insulin, or remission and relapse.
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Some People With Diabetes Can Develop An Unhealthy Relationship Or Fixation On Food This Can Lead To Something Called Disordered Eating Behaviour Or Possibly An Eating Disorder
Diabetes and food are closely linked. Having diabetes can mean a bigger focus on diet, weight and body image, so its not surprising that some people can start to feel negatively about food. Here we look at eating disorders and diabetes and explore what can be done to overcome this.
Disordered eating isnt the same as having a diagnosed eating disorder. But the signs and behaviours are similar, like skipping insulin for weight loss, or binge eating and making yourself sick. But one can lead to the other, so its really important you get help before things get worse.
These eating problems are more common than you think youre not alone in this. And they can happen to anyone, not just because you have diabetes. Here well help you recognise disordered eating behaviour, find out what can cause it and youll read how some people have overcome this.
Ive realised Im not the only one whos been through something like this. Peer support was invaluable to me. – Lynsey, who had an eating disorder
What Should Healthcare Professionals Be Aware Of
Its important that health care professionals know about these risk factors when working with people with type 1 diabetes. Knowing how to spot the signs of an eating disorder, and address these risk factors in people with type 1 diabetes can help to prevent eating disorders and intervene early. You should also use sensitive language in consultations for diabetes, particularly when communicating messages around weighing and glucose management.
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Diabetes: A Risk Factor
A multitude of factors contribute to the start, development and maintenance of eating disorders. Certain aspects of diabetes can be contributing factors.
Starting a diet can be a trigger for these disorders. Since a nutritional intervention is part of diabetes treatment, a teen already predisposed to developing an ED will be even more vulnerable if diabetic because managing the disease requires the intake of carbohydrates to be counted and the diet to be strictly controlled.
Most people newly diagnosed with type 1 diabetes tend to gain weight when they begin treatment. Many of these people are simply regaining the weight lost because of the disease before their diagnosis. Insulin is a hormone that can promote the storage of body fat in sedentary people. It can also promote the development of muscle mass in physically active people, which can increase their weight on the scale. For some people, weight gain can be undesirable and make them feel that they are losing control of their bodies.
A chronic disease like diabetes can be stressful. Some mental health specialists believe that one of the functions of an eating disorder is to deal with painful emotions that are difficult to control. Thus, stress and emotions can play a role in the development or maintenance of an ED.
Type 1 Diabetes And Eating Disorders: How Can They Be Detected And Treated
Published Dec 16, 2021 By Claudia Lima
Type 1 diabetes is treated with regular injections of insulin and a carefully balanced diet. This change in relationship with food can provoke negative mindset and even disordered eating in those who are particularly susceptible or affected.What are these disorders? How are they triggered? How can they be prevented?
We explain it all in our article!
There is a link between type 1 diabetes and eating disorders despite the importance of a balanced diet in the management of this disease.Diabetes is a chronic autoimmune condition, caused by the dysfunction of mechanisms regulating blood sugar. Type 1 diabetes is also called insulin-dependent, and results from the destruction of pancreas cells responsible for generating insulin. This disease is treated by insulin injections, which lower blood sugar levels.Patients with type 1 diabetes have a high risk of developing eating disorders.
Eating disorders are complex disorders characterized primarily by abnormal eating habits, an intense fear of gaining weight, and a great concern for body image. The different types of eating disorders are anorexia, bulimia, and binge eating disorder .About 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime. The diagnosis is most common in individuals aged between 16 and 40. About 26% of people with eating disorders attempt suicide.
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Dangerous Symptoms To Look For
Since insulin is necessary for people living with diabetes to manage their blood glucose levels, skipped or reduced dosages can be extraordinarily dangerous. In many cases, those suffering from diabulimia will experience diabetic ketoacidosis at some point. If DKA is not treated, it can result in a coma or even death. Some dangerous symptoms of DKA to look for in those suffering from diabulimia include:
- Skipping menstrual periods
Talk to a medical professional if you or a loved one are experiencing any of the symptoms for diabulimia or if youre struggling with your body image.
Disordered Eating In People With Type 1 Diabetes Mellitus
People with Type 1 Diabetes have a higher prevalence eating disorders, which often presents initially as disordered eating. Disordered eating includes thoughts and behaviours regarding weight, shape, eating and medicine usage that do not meet diagnostic criteria for an eating disorder but are harmful to health and wellbeing.
Materials developed by the Statewide Diabetes Clinical Network and Diabetes Queensland support clinicians and services to recognise and respond to disordered eating.
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The Relationship Between Eating Disorders And Type 1 Diabetes
As mentioned, people living with diabetes are required to put in a certain level of focus and restraint when creating meal plans, measuring out their food portions, and monitoring their overall food intake in relation to insulin. This is especially important for carbohydrates and sugars. Due to the requirement for this level of focus, its not uncommon for unhealthy relationships with food to develop. This is especially true in regard to adolescents and teens, but it can occur at any age.
During adolescence, body image becomes more scrutinized and your relationship with food may change, especially if youve been living with type 1 diabetes for years. This becomes increasingly difficult if you have friends or family members who give you constant input about what you should or should not be eating. When you have to be hyperaware of what you eat, how your body reacts to it, and what is considered attractive in society, it can create mental health problems that develop into eating disorders.
If an individual with type 1 diabetes develops an eating disorder, its commonly paired with diabetes distress and even ongoing fears of hypoglycemia, depression, anxiety, and more. To better understand signs and symptoms of eating disorders, well explore some of the most common ones.