T1DE describes the experience of having an eating disorder while living with type 1 diabetes. Although it is not currently a formal medical diagnosis, the term is increasingly recognised by healthcare professionals. It is sometimes referred to as “diabulimia” in the media.
People with T1DE may restrict insulin to control their weight or experience other eating disorder behaviours, such as food restriction, over-exercising, or purging.
Signs and symptoms
Signs that someone may be experiencing T1DE can include:
- Frequently missing, reducing, or manipulating insulin doses
- Significant changes in weight or difficulty maintaining weight
- Preoccupation with weight, food, calories, or blood glucose levels
- Restricting food or avoiding certain foods
- Excessive exercise
- Binge eating or purging
- Frequently high or unpredictable blood glucose levels
- Increased thirst and urination
- Feeling tired, weak, dizzy, or unwell
- Avoiding diabetes appointments or becoming secretive about diabetes management
Why is insulin restriction dangerous?
Restricting insulin can cause diabetic ketoacidosis (DKA), a serious and potentially life-threatening complication of type 1 diabetes. DKA occurs when there is not enough insulin in the body, causing blood glucose to rise and the body to produce high levels of ketones, which make the blood acidic.
Symptoms of DKA can include excessive thirst, frequent urination, nausea or vomiting, abdominal pain, deep or rapid breathing, dehydration, extreme tiredness, and a fruity-smelling breath. DKA requires urgent medical treatment.
Living with type 1 diabetes may also increase the risk of developing an eating disorder due to factors such as:
- Regular monitoring of weight and blood glucose
- Focusing on food labels and carbohydrate intake
- Food and weight discussions during medical appointments
- Needing to eat to treat low blood sugar
- Stigma and negative attitudes surrounding diabetes
