Diabulimia among adolescents and young adults with Type 1 diabetes

Abstract

Eating disorders are common in young people with diabetes, where manipulation of insulin is often used to manage body weight. Deteriorating metabolic control in adolescents with Type 1 diabetes has been closely linked with the emergence of eating disorders. The practice of reducing calories by omitting insulin is referred to as diabulimia. This practice is known to compromise metabolic control resulting in subsequent detrimental health outcomes. Diabulimics risk microvascular complications including renal failure and peripheral neuropathy of the extremities; as well as macrovascular complications, such as, heart attack and stroke. Studies have shown that diabulimic behaviours lead to a threefold increase in the risk of death compared to non-diabetic subjects. While this disorder is relatively well known to endocrinologists who treat a large numbers of patients with type 1 diabetes, it is not often recognized by primary health care providers or members of the individual’s family. If diabulimia is detected early, interventions can be implemented to minimize the risk of early morbidity and mortality.