Diabulimia – What Is It?

Diabulimia is a relatively new eating disorder made up of two diseases that are dangerous on their own: insulin-based diabetes and bulimia. The name is also derived from these.

Diabulimia - what is it?

When Diabulimie is a relatively new eating disorder, which is composed of two diseases alone already dangerous: an insulin-based diabetes and bulimia. The name is also derived from these.

The Diabulimie thus includes both the risk factors of an endocrine disorder and an eating disorder. When the latter is combined with a hormone deficit, the consequences can be fatal.

What role does diabetes play in diabulemia?

Specifically, this is about type 1 diabetes, which requires exogenous insulin because the patient’s pancreas does not synthesize it in sufficient quantities. The prevailing insulin deficiency is a major cause of weight loss in those affected.

The hormone is necessary for the transport of glucose molecules into the cells for them to function. If there is a lack of insulin, the glucose remains in the bloodstream until it is generally removed via the kidneys. In some cases this results in extreme weight loss.

Under normal circumstances, young people with type 1 diabetes will regain weight after diagnosis and treatment with insulin and a regulated diet.

In the case of diabulimia, however, the effect of insulin on the metabolism is exploited, so that the state of health does not improve and instead the weight is greatly reduced.


Which patient type is affected?

Diabulimia occurs in both men and women, but predominates in the latter. The person affected usually has the following characteristics:

  • Type 1 diabetes occurs at a young age,
  • Intelligence as well as high academic education,
  • perfectionist disposition,
  • low self-esteem
  • complex family relationships : poor problem-solving ability, high demands and deficit, emotion-focused communication among family members,
  • Signs of depression, although it is unclear whether these occurred before the actual depression or before the dibulimia.

The person affected by bulimia, who also has type 1 diabetes, replaces the binge eating, the subsequent vomiting and excessive exercise by using the insulin to lose weight.

Insufficient amounts of insulin are deliberately administered, which can lead to a hyperglycemic coma – a dangerous and life-threatening situation. However, the morbid desire to be particularly thin prevails.

This misuse of insulin begins as a kind of game that cannot be ended and leads to an exacerbation of symptoms.

Patients who do not have an eating disorder carefully monitor their insulin doses and eating habits to avoid dangerous blood sugar spikes. On the other hand, they are often overweight.

What complications can arise?

In the case of diabulemia, the effects of insulin-based diabetes intensify and accelerate:

  • Increased risk of kidney damage requiring dialysis
  • Effects on the retina that can cause blindness,
  • Endangering the peripheral blood circulation, which can result in a diabetic foot and, in severe cases, an amputation,
  • late or missed menstruation,
  • stopping growth,
  • Hair loss and skin problems,
  • Ketoacidosis due to hyperglycemia, which can result in irreversible cell damage and coma,
  • frequent occurrence of neuropathy due to toxic factors of acidosis acting on the nerves,
  • the average age at death is 45 years.

These symptoms make it clear that the prognosis of the affected people is not very positive.

Which factors indicate diabulimia?

Some authors advise both the family and the facultative environment of patients with type 1 diabetes to pay attention to certain aspects that may indicate an eating disorder. These include, for example:

  • Phases in which the diabetes is barely controlled
  • excessive weight loss
  • Hospital admissions for hypoglycemia or hyperglycemia
  • falsified control data of the patient compared to laboratory results
Diabulimia and its consequences

Diabulimia is a difficult disease to diagnose and is mostly unknown to non-specialized doctors. Your prognosis is particularly serious, which is why a diagnosis must be made early in order to initiate appropriate treatment promptly.

Treatment is complex and centered on an endocrine disorder that involves both emotional and psychological factors. A multidisciplinary team is therefore required, which should consist of the following groups of people:

  • Family doctor
  • Psychologist
  • Nutritionist
  • Endocrinologist

It is important that they maintain communication with one another in order to be able to implement appropriate treatment. This also includes the patient’s family.

Finally, it can be said that diabulimia is more than just an eating disorder or a diabetes disease.

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