Diabulimia: Difference between revisions
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{{Infobox medical condition | |||
| name = Diabulimia | |||
| synonyms = [[Eating disorder]] in [[type 1 diabetes]] | |||
| field = [[Endocrinology]], [[Psychiatry]] | |||
| symptoms = [[Hyperglycemia]], [[weight loss]], [[fatigue]], [[dehydration]], [[ketoacidosis]] | |||
| complications = [[Diabetic ketoacidosis]], [[retinopathy]], [[neuropathy]], [[nephropathy]], [[cardiovascular disease]] | |||
| onset = Typically during [[adolescence]] or [[young adulthood]] | |||
| duration = Chronic | |||
| causes = Intentional [[insulin]] restriction | |||
| risks = [[Body image]] issues, [[psychological stress]], [[peer pressure]] | |||
| diagnosis = Based on [[clinical history]], [[blood glucose]] levels, [[HbA1c]] tests | |||
| differential = [[Anorexia nervosa]], [[bulimia nervosa]], [[type 1 diabetes]] | |||
| treatment = [[Insulin therapy]], [[nutritional counseling]], [[psychotherapy]] | |||
| prognosis = Variable; improved with treatment | |||
| frequency = Unknown, but more common in [[females]] with [[type 1 diabetes]] | |||
}} | |||
'''Diabulimia''' is an unofficial term created from the fusion of the words ''diabetes'' and ''bulimia''. This term denotes a hazardous eating behavior exhibited by some individuals with [[Type 1 diabetes]]. Afflicted individuals intentionally underdose on insulin, a crucial hormone for glucose regulation, with the motive of losing weight. | '''Diabulimia''' is an unofficial term created from the fusion of the words ''diabetes'' and ''bulimia''. This term denotes a hazardous eating behavior exhibited by some individuals with [[Type 1 diabetes]]. Afflicted individuals intentionally underdose on insulin, a crucial hormone for glucose regulation, with the motive of losing weight. | ||
Though "diabulimia" is not formally acknowledged in the medical or psychiatric sectors, terms such as “disturbed eating behavior” (DEB), “disordered eating behavior”, or simply “disordered eating” (DE) commonly emerge in literature that discusses this phenomenon. | |||
Though "diabulimia" is not formally acknowledged in the medical or psychiatric sectors, terms such as | |||
=== Origin and Background === | === Origin and Background === | ||
Diabulimia generally commences during adolescence and exhibits a higher prevalence in women than in men. The onset of this behavior can be correlated with the challenges associated with managing Type 1 diabetes and the anxiety over potential diabetic complications. | Diabulimia generally commences during adolescence and exhibits a higher prevalence in women than in men. The onset of this behavior can be correlated with the challenges associated with managing Type 1 diabetes and the anxiety over potential diabetic complications. | ||
=== Symptoms === | === Symptoms === | ||
The ramifications of diabulimia can be both immediate and long-term, severely impacting the individual's overall health. | The ramifications of diabulimia can be both immediate and long-term, severely impacting the individual's overall health. | ||
==== Short-Term Symptoms ==== | ==== Short-Term Symptoms ==== | ||
| Line 20: | Line 32: | ||
* Severe ketonuria, and in cases of diabetic ketoacidosis (DKA), pronounced ketonemia | * Severe ketonuria, and in cases of diabetic ketoacidosis (DKA), pronounced ketonemia | ||
* Depressed sodium levels | * Depressed sodium levels | ||
==== Medium-Term Symptoms ==== | ==== Medium-Term Symptoms ==== | ||
When diabulimia persists untreated, medium-term symptoms, in addition to short-term symptoms, manifest: | When diabulimia persists untreated, medium-term symptoms, in addition to short-term symptoms, manifest: | ||
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* Fluid replacement-induced edema | * Fluid replacement-induced edema | ||
* Elevated cholesterol levels | * Elevated cholesterol levels | ||
==== Long-Term Symptoms ==== | ==== Long-Term Symptoms ==== | ||
For individuals with Type 1 diabetes oscillating between compliant insulin use and phases of diabulimia, these grave symptoms may emerge: | For individuals with Type 1 diabetes oscillating between compliant insulin use and phases of diabulimia, these grave symptoms may emerge: | ||
| Line 43: | Line 53: | ||
* [[Osteoporosis]] | * [[Osteoporosis]] | ||
* Death | * Death | ||
=== Identifying Diabulimia === | === Identifying Diabulimia === | ||
Clinicians can suspect diabulimia in patients presenting the following: | Clinicians can suspect diabulimia in patients presenting the following: | ||
| Line 51: | Line 60: | ||
* Non-adherence to diabetes medication prescriptions | * Non-adherence to diabetes medication prescriptions | ||
* Clinical records inconsistent with the HbA1c values | * Clinical records inconsistent with the HbA1c values | ||
=== Risk and Complications === | === Risk and Complications === | ||
Diabetic ketoacidosis (DKA), a life-threatening complication resulting from insufficient insulin, is frequently observed in individuals with diabulimia. The body, starved of energy due to the insulin deficiency, rapidly deteriorates, and without prompt intervention, this condition can be fatal. | Diabetic ketoacidosis (DKA), a life-threatening complication resulting from insufficient insulin, is frequently observed in individuals with diabulimia. The body, starved of energy due to the insulin deficiency, rapidly deteriorates, and without prompt intervention, this condition can be fatal. | ||
The misuse of insulin combined with excessive food consumption leading to ketoacidosis may indicate the need for psychological support. Sometimes, these actions may express a desire to escape challenging environments, or more rarely, manifest suicidal inclinations. | The misuse of insulin combined with excessive food consumption leading to ketoacidosis may indicate the need for psychological support. Sometimes, these actions may express a desire to escape challenging environments, or more rarely, manifest suicidal inclinations. | ||
==Treatment== | ==Treatment== | ||
There are no specific guidelines for the treatment of diabetes and disordered eating, but the standard approach for treatment of two complex conditions as multidisciplinary team of professionals which in this case could include an endocrinologist, dietician, psychologist, etc. | There are no specific guidelines for the treatment of diabetes and disordered eating, but the standard approach for treatment of two complex conditions as multidisciplinary team of professionals which in this case could include an endocrinologist, dietician, psychologist, etc. | ||
=== See Also === | === See Also === | ||
* [[Diabetes mellitus]] | * [[Diabetes mellitus]] | ||
* [[Bulimia nervosa]] | * [[Bulimia nervosa]] | ||
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{{No image}} | {{No image}} | ||
{{No image}} | {{No image}} | ||
Latest revision as of 05:35, 4 April 2025
| Diabulimia | |
|---|---|
| Synonyms | Eating disorder in type 1 diabetes |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Hyperglycemia, weight loss, fatigue, dehydration, ketoacidosis |
| Complications | Diabetic ketoacidosis, retinopathy, neuropathy, nephropathy, cardiovascular disease |
| Onset | Typically during adolescence or young adulthood |
| Duration | Chronic |
| Types | N/A |
| Causes | Intentional insulin restriction |
| Risks | Body image issues, psychological stress, peer pressure |
| Diagnosis | Based on clinical history, blood glucose levels, HbA1c tests |
| Differential diagnosis | Anorexia nervosa, bulimia nervosa, type 1 diabetes |
| Prevention | N/A |
| Treatment | Insulin therapy, nutritional counseling, psychotherapy |
| Medication | N/A |
| Prognosis | Variable; improved with treatment |
| Frequency | Unknown, but more common in females with type 1 diabetes |
| Deaths | N/A |
Diabulimia is an unofficial term created from the fusion of the words diabetes and bulimia. This term denotes a hazardous eating behavior exhibited by some individuals with Type 1 diabetes. Afflicted individuals intentionally underdose on insulin, a crucial hormone for glucose regulation, with the motive of losing weight.
Though "diabulimia" is not formally acknowledged in the medical or psychiatric sectors, terms such as “disturbed eating behavior” (DEB), “disordered eating behavior”, or simply “disordered eating” (DE) commonly emerge in literature that discusses this phenomenon.
Origin and Background[edit]
Diabulimia generally commences during adolescence and exhibits a higher prevalence in women than in men. The onset of this behavior can be correlated with the challenges associated with managing Type 1 diabetes and the anxiety over potential diabetic complications.
Symptoms[edit]
The ramifications of diabulimia can be both immediate and long-term, severely impacting the individual's overall health.
Short-Term Symptoms[edit]
- Constant thirst and urination
- Elevated appetite
- High blood glucose levels, often exceeding 600 mg/dL
- Weakness and fatigue
- Glucose presence in urine
- Diminished concentration abilities
- Electrolyte imbalance
- Severe ketonuria, and in cases of diabetic ketoacidosis (DKA), pronounced ketonemia
- Depressed sodium levels
Medium-Term Symptoms[edit]
When diabulimia persists untreated, medium-term symptoms, in addition to short-term symptoms, manifest:
- Muscle degeneration
- GERD (Gastroesophageal Reflux Disease)
- Indigestion
- Significant weight loss
- Protein in urine
- Moderate to severe dehydration
- Fluid replacement-induced edema
- Elevated cholesterol levels
Long-Term Symptoms[edit]
For individuals with Type 1 diabetes oscillating between compliant insulin use and phases of diabulimia, these grave symptoms may emerge:
- Profound kidney damage, potentially resulting in kidney failure and necessitating transplantation
- Blindness due to retinal diseases induced by prolonged high blood sugar
- Acute neuropathy, primarily impacting hands and feet
- Overwhelming fatigue
- Edema, especially when blood sugar levels stabilize
- Heart-related issues
- High cholesterol levels
- Osteoporosis
- Death
Identifying Diabulimia[edit]
Clinicians can suspect diabulimia in patients presenting the following:
- Unpredictable spikes in Hemoglobin A1c
- Weight loss without a clear cause
- Absence of fingerprick marks
- Non-adherence to diabetes medication prescriptions
- Clinical records inconsistent with the HbA1c values
Risk and Complications[edit]
Diabetic ketoacidosis (DKA), a life-threatening complication resulting from insufficient insulin, is frequently observed in individuals with diabulimia. The body, starved of energy due to the insulin deficiency, rapidly deteriorates, and without prompt intervention, this condition can be fatal. The misuse of insulin combined with excessive food consumption leading to ketoacidosis may indicate the need for psychological support. Sometimes, these actions may express a desire to escape challenging environments, or more rarely, manifest suicidal inclinations.
Treatment[edit]
There are no specific guidelines for the treatment of diabetes and disordered eating, but the standard approach for treatment of two complex conditions as multidisciplinary team of professionals which in this case could include an endocrinologist, dietician, psychologist, etc.
