Eating Disorder: Increasing Risk in Diabetics | metropolises

Diabulimia, when the patient stops taking insulin to lose weight, is more common in young diabetic girls

People with diabetes are 2.5 to 3 times more likely to develop eating disorders than those without the disease in the same age group. And the problem can easily go unnoticed by doctors and family members. The scenario is more worrying in young people with type 1 diabetes, who may have a condition called diabulimia – when they stop taking insulin in order to lose weight.

On this June 2nd, the World Day of Alert for Eating Disorders, the Brazilian Society of Diabetes reinforces a campaign launched especially to draw attention to these cases, called #DiabulimiaNao.

Although still largely unknown, diabulimia usually appears in pre-adolescence and adolescence and can affect up to a third of diabetic girls between 16 and 22 years old. In addition to failing to take or skipping insulin doses, these patients may also exhibit so-called compensatory behaviors, such as vomiting, use of laxatives and diuretics, or excessive physical activity.

“At this age, there is usually dissatisfaction with the body and the very nature of diabetes, with more attention to food, carbohydrate counting, diet planning, it ends up leaving aside more those who are predisposed”, explains endocrinologist Claudia Pieper, coordinator of the Department of Psychiatry, Psychology and Eating Disorders of the Brazilian Society of Diabetes and Member of the Academy for Eating Disorders. It is even more serious in cases where there are other mental health disorders involved, such as anxiety or depression.

decompensated diabetes

The lack of insulin leads to excess blood sugar that causes metabolic changes and makes the body use fat reserves, promoting weight loss. The person ends up eliminating glucose and excess calories through the urine as well. But uncompensated diabetes brings serious, potentially fatal, risks, such as malnutrition, impaired growth, a greater chance of early chronic complications (with only 4 or 5 years of disease) such as retinopathy (a complication that occurs when excess glucose in the blood damages blood vessels within the retina), damage to the kidneys, diabetic neuropathy, among others.

The diagnosis of diabulimia is not always easy. Attention should be paid to the patient’s warning signs, such as frequently forgetting the glucometer (device that measures blood glucose), not correctly recording dosage results, not wanting to weigh themselves, asking for more restricted diets, having high blood glucose levels in exams that show the average of the last months, doing excessive physical activity, having hospitalizations for diabetic ketoacidosis (high blood glucose), pens or bottles of insulin that take time to finish.

The treatment must be taken care of by a multidisciplinary team, including physicians, psychologists and psychiatrists. “These are two very stigmatized diseases, but they can be treated and it is possible to recover from an eating disorder”, says an expert.

Although the best-known eating disorder is anorexia – when a person is terrified of getting fat and starts restricting more and more food – the most prevalent in the world is binge eating, in which the individual comes uncontrollably, but does not exhibit compensatory behaviors. This favors weight gain and obesity, with a higher risk of developing type 2 diabetes. Anorexia is rare in diabetics. (Source: Einstein Agency)


Anyone with diabetes knows that there are many foods that should be avoided, especially those rich in vitamins, salt and, of course, sugar. On the other hand, there is also a list of foods that should be included in the menu to help keep blood sugar levels under control.
One of the natural foods that can help control diabetes is salmon, which is rich in essential nutrients such as vitamin D, protein and niacin. Not to mention omega-3s, which can help protect heart health and reduce heart-associated inflammation.

Orange is another natural food that can help control diabetes, because in addition to helping to reduce cholesterol levels, it has fibers that help compress the time when fruit sugar is absorbed in the body. In this way, it acts in the control of blood glucose. In addition, it has a low glycemic index.
Kale is rich in several essential nutrients for those with diabetes. This is because in addition to having vitamin A, C, B6 and K, it has folic acid, magnesium, calcium, fiber, oxidants and bile sequestrants, substances that lower cholesterol and limit the absorption of fat by the body.

Oats are one of the natural foods that contain beta-glucan in their composition, a type of heart-healthy fiber that slows down digestion and, consequently, prevents uncontrolled blood sugar.
Beans are foods rich in fiber and protein with a low glycemic index, which help prevent fluctuations in blood sugar levels and also delay the rise in glucose levels.

According to experts from the Annals of Family Medicine, cinnamon is quite satisfactory for helping to control blood sugar in people with type 2 diabetes. This is because it is able to lower glycated hemoglobin levels and improve insulin availability
The consumption of small portions (at least five times a day) of flaxseeds is indicated for those with diabetes. In addition to being a source of magnesium, which helps control the release of insulin in the body and control blood sugar, it is rich in fiber and good vitamins.

Excellent source of unsaturated vitamins, which lowers bad cholesterol and increases good cholesterol, low in carbohydrates and rich in magnesium, protein, iron, zinc, fiber and vitamin B and E, almonds help reduce the risk of type 2 diabetes and also helps in disease control
Indicated for those with diabetes, heart disease and cancer, green tea helps regulate glucose in the body and is rich in polyphenols and antioxidants.

Apple cider vinegar is another natural food that helps in controlling diabetes. That’s because it helps slow the absorption of sugar and significantly improves insulin sensitivity or resistance to it. Daily consumption of the equivalent of two tablespoons of apple cider vinegar added to meals is recommended.

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