Chances are you know someone with diabetes type 1 or the eating disorder bulimia nervosa. However, what’s more uncommon is having both conditions at once, which has been coined “diabulimia.”
Dr. Ovidio Bermudez, the chief medical officer and medical director of Child and Adolescent Services at the Eating Recovery Center explained in an email that diabulimia is a word used more among the general public. It’s not a true diagnosis.
“The dual diagnosis of an eating disorder and type 1 diabetes is often referred to as ‘diabulimia,’ although this is not a medically recognized term and it is not an accurate description,” Bermudez said.
The term used among health care professionals for diabulimia is ED-DMT1. Diabulimia or ED-DMT1 is diagnosed when a person intentionally misuses insulin to control weight.
This includes decreasing insulin intake, avoiding any insulin intake, waiting longer to take the right amount of insulin, or tampering with the insulin so it doesn’t work properly.
When anyone with type 1 diabetes uses one of the above techniques to control weight, it can lead to high blood glucose levels, or hyperglycemia, as well as excretion of glucose in urine, which leads to weight loss.
This is considered to be a purging of calories.
However, the condition is complicated because a person diagnosed with ED-DMT1 may not even be diagnosed with bulimia or have typical symptoms, like self-induced vomiting or binge-eating.
A person suffering from diabulimia may only refrain from using insulin after an actual binge, or just after eating more than usual, as a way to purge the calories.
The symptoms of diabulimia can be pretty broad and include typical eating disorder behaviors, but some people have normal eating patterns and only manipulate the insulin.
Bermudez said that there are four major factors that can contribute to the development of an eating disorder in a person with type 1 diabetes:
1) Emphasis on food and diet restraint
Carbohydrate counting and meal planning are important parts of diabetes management, and this can create an unhealthy focus on food, numbers and control.