What is diabulimia?

When an eating disorder is combined with a hormonal deficit, the consequences are devastating. Diabulimia is a relatively recent disease, which It is caused by the combination of two diseases that alone are very dangerous, insulin-dependent diabetes and bulimia, hence its name.

What is the role of diabetes in diabulimia?

In the case at hand, we are going to refer to type I diabetes that needs exogenous insulin contributions because the patient's pancreas does not synthesize the necessary amount.

The lack of insulin is an important factor in the weight loss of these patients. Insulin is necessary to bring glucose molecules to cells for proper functioning. If there is no insulin, the sugar remains in the bloodstream until it is removed, usually by the kidney, and leads to weight loss, sometimes extreme.

Under normal conditions, young patients with type I diabetes, after diagnosis and chronic insulin treatment accompanied by very regulated feeding, begin to regain their weight. In diabulimia, the patient takes advantage of the action of insulin on the metabolism To, far from recovering their state of health and weight, maintain an excessively low weight.

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Patient type

Diabulimia can appear in both sexes though, It is clearly majority in the female sex. The type patient with diabulimia usually has the following characteristics:

• Girls in which type I diabetes begins at an early age.
• Smart, with good academic and perfectionist results.
• With very low self-esteem.
• Complex family environments: low resolution of problems, high level of demand and deficit in the emotional communication of its members.
• It is common appearance of depressive traits without knowing very well if it was before depression or diabulimia.

The patient with bulimia who also suffers from type I diabetes begins to replace binge eating, subsequent vomiting and excessive exercise due to the use of the insulin to lose weight.

Clearly insufficient doses are injected that sometimes produce hyperglycemic commas, which are very serious episodes that can compromise your own life; however, the desire to stay thin, sickly thin is stronger.

This perverse use of insulin begins as a kind of game in which they are entangled without the possibility of leaving, as the symptoms progress.

Patients without bulimic disorder who control insulin doses and intake well, want to avoid sugar rises at all costs because they are very unpleasant and dangerous. These patients tend to be overweight.

Read also: Bulimia, everything you need to know

Complications

In patients with diabulimia, the effects of insulin-dependent diabetes increase and accelerate.

• Increase the risk of Kidney damage which may require dialysis.
• It affects the retina being able to produce blindness.
• Commit to peripheral blood circulation giving rise to diabetic foot, which in severe cases ends in amputation.

• Delay, or no appearance, of menstruation.
• Growth stops
• waste of hair, skin problems and a long etcetera.
• Ketoacidosis due to hyperglycemia maintained in the blood that can cause irreversible cell damage and coma.
• The appearance of neuropathies by the toxic factor of metabolic acidosis on the nerves.
• The average age of death of patients with diabulimia is 45 years.

As we can see, the prognosis of this type of patients is very bleak.

Factors that make you suspect diabulimia

Many authors recommend to the family and medical environment of patients with type I diabetes that keep watch certain factors that can make you suspect a eating disorder that accompanies diabetes itself, such as:

• Phases of great lack of control of diabetes
• Great weightloss.
• Hospital admissions for hypo or hyperglycemia.
• Falsehood of the control data of the patient when compared with laboratory tests.

Diabulimia is a disease of very difficult diagnosis and quite unknown by non-specialized medical staff. Its prognosis is very serious and we must be attentive to make an early diagnosis that allows us to quickly begin treatment.

It is a complex treatment of an endocrine disease with involvement of the emotional and psychic sphere and, therefore, requires the performance of a multidisciplinary team formed, at least, by:

• Primary attention doctor.
• Psychologist
• Nutritionist.
• Endocrinologist

All professionals involved must maintain a fluid communication channel between them, in order to to adapt the medical and psychological treatments, and also with the family for the best benefit of the patient.

In conclusion, the devil it's more than an eating disorder and much more than insulin dependent diabetes.