Eating Disorders and Insulin Restriction in Type 1

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Although eating disorders are life-threatening illnesses, people don’t typically associate them with type 1 diabetes. But that’s not the case: insulin restriction can be deadly.

Prevention and Recovery from Eating Disorders in Type 1 Diabetes: Injecting Hope (Routledge Press) is based on interviews with women in recovery.

To find out more about this,  we spoke with Ann Goebel-Fabbri, Ph.D., a clinical psychologist who worked at Joslin Diabetes Center and was an Assistant Professor of Psychiatry at Harvard Medical School for over 15 years. (She is currently in private practice in which she treats patients with eating disorders and type 1 diabetes and consults to medical teams and loved ones about how to optimally help them.)

“Girls and women with type 1 diabetes are close to 2.5 times more likely to develop an eating disorder than those without the condition,” says Dr. Goebel-Fabbri, who is the author of Prevention and Recovery from Eating Disorders in Type 1 Diabetes: Injecting Hope.

Women with both type 1 diabetes and an eating disorder often practice insulin restriction as a means of calorie purging, she explains. By skipping or reducing insulin doses, they’re able to quickly lose weight. Blood glucose levels creep higher and higher and some of that glucose is then excreted in the sugar-filled urine. As a result, the body doesn’t absorb carbohydrates and sugars and drastic weight loss occurs.

3 Responses to Eating Disorders and Insulin Restriction in Type 1

  1. Walter Wasylko says:

    I’m a Type 1 for 48 years with bowel incontinence due to Cerebral Palsy autonomic neuropathy (AN). My gastroenterologist wasn’t able to diagnose specifically whether it could be connected with an eating disorder since AN is considered a symptom of long-term T1 complication.

  2. Michael O'Meara says:

    As a 65 year old male with type 1 diabetes for 54 years, I am curious about any such studies that may have focused on boys, male teens and/or men.

    The treatment modalities, technologies and insulins available in the 60s-early 80’s made it more challenging for physically active males to be able to avoid high blood glucose levels while more importantly avoiding the lows that forced an unpleasant interruption in physical activities and drew unwanted attention to the disease.

    In hindsight, this learned perspective that emerged from a learned tolerance for the experiences of high bg (and amazing “luck” related to avoiding the complications of high HbA1c levels) made remaining thin and relatively free of low bg an acceptable trade-off.

    For the last 20+ years, I have watched my intake, checked my bg 6+ times a day, treated high bg with ss dosing, visited my providers at least 4 times a year and now I struggle more with low bg and am obese, but , hey, my HbA1c scores are now below 7. Success? Now, my medical Team says, “…all (I) have to do differently is become more active and be more focused on checking (my) bg levels.” (Please refer to first and second paragraphs.)

    Point being: anymore, endocrinologists must help their patients with diabetes by implementing a Team-approach that includes, at least, a Nurse Practitioner (diabetes educator) and RD. Together, they can form a wholistic perspective that is better able to perceive, understand and respond to each of their patients’ unique collection of thoughts, emotions, questions, needs, behaviors and experiences. This may be challenging, but it pales in comparison with the challenges facing the person with diabetes.

    • dr suresh says:

      what regimen/dose of insulin you are following?
      what are your renal function reports?with increasing age low bl sugar is common,,renal/hepatic functions are affected.hence detals of reports required.

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