Type 1 Diabetes with Disordered Eating (T1DE)
T1DE, also known as diabulimia, is a serious eating disorder that people with type 1 diabetes can develop. It refers to the practice of individuals with type 1 diabetes deliberately reducing or omitting their insulin doses to lose weight.
This can happen alongside other behaviours such as restricting the food eaten, over-exercising, binging, vomiting or using laxatives to try to control weight. Some people don’t stop or reduce their insulin but instead control their weight and shape through food restriction or over-exercise, which indirectly limits the amount of insulin required.
T1DE is a serious condition as when someone has type 1 diabetes, they need insulin to survive. So without it, there can be life-threatening consequences.
It can be very difficult to tell if a friend or family member has developed an eating disorder like diabulimia. People affected by the condition tend to hide it, often very well.
There are some signs that might suggest someone has a problem and isn’t taking their insulin:
- losing weight, or their weight’s going up and down
- a high HbA1c
- going into hospital a lot with diabetic ketoacidosis (DKA) or high blood sugar levels
- developing complications of diabetes when they’re young
- injecting in secret or not wanting to inject
- not testing blood sugar levels or not wanting to test
- not wanting to be weighed at the clinic
- missing diabetes appointments
- feeling depressed or anxious
- for women — irregular or stopped periods, or a delay in periods starting
- changes in appetite
- obsessing about counting calories
But not everyone with diabulimia will show all of these signs. And it’s important to remember that sometimes they’ll get some of these signs for other reasons such as going through puberty or it could be they’re still learning to look after their diabetes.
If you’re worried someone has diabulimia, it can be difficult to know how to talk to them about it. Diabulimia is really serious, and can make someone very sick very quickly, so it’s best to bring it up if you’re worried.
Here are some tips to help:
- prepare what you’re going to say
- find a time when you’re not cross or upset with them, and you know you’re not going to be interrupted
- don’t judge or blame them — let them know that you’re talking about it because you care about them and you’re worried.
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