Diabulimia

The short-term symptoms of diabulimia are:

• Frequent and excessive urination
• Frequent and excessive thirst
• Frequent and excessive hunger
• High blood glucose levels (often over 600 mg/dL or 33 mmol/L)
• Weakness
• Fatigue
• Large amounts of glucose in the urine
• Inability to concentrate
• Electrolyte disturbance
• Severe ketonuria, and, in DKA, severe ketonemia
• Low sodium levels

These are the medium-term symptoms of diabulimia. They are prevalent when diabulimia has not been treated and hence also include the short-term symptoms.

• Muscle atrophy
• GERD
• Indigestion
• Severe weight loss
• Proteinuria
• Moderate to severe dehydration
• Edema with fluid replacement
• High cholesterol

If a person with type 1 diabetes who has diabulimia suffers from the disease for more than a short time—usually due to alternating phases during which insulin is injected properly and relapses during which they have diabulimia—then the following longer-term symptoms can be expected:

• Severe kidney damage: high blood sugar can overwork the kidneys, eventually leading to kidney failure and the need for a kidney transplant[6]
• Severe neuropathy (nerve damage to hands and feet)
• Extreme fatigue
• Edema (during blood sugars controlled phases)
• Heart problems
• Retinal damage and subsequent vision problems
• High cholesterol
• Osteoporosis
• Death

Often, people with type 1 diabetes who omit insulin injections will have already been diagnosed with an eating disorder such as anorexia nervosa, bulimia nervosa, or EDNOS. These individuals often think diabulimia is less common than it is and do not know how difficult it is to overcome. Unlike anorexia and bulimia, diabulimia sometimes requires the afflicted individual to stop caring for a medical condition. Unlike vomiting or starving, there is sometimes no clear action or willpower involved.

Many articles and studies further conclude that diabetic females have, on average, higher body mass index (BMI) than their nondiabetic counterparts. Girls and young adult women with higher BMIs are also shown to be more likely to have disordered eating behavior (DEB).[7][8] Many authoritative articles show that preteen and teenage girls with type 1 diabetes have significantly higher rates of eating disorders of all types than do girls without diabetes.[4][9][10][11] This condition can be triggered or exacerbated by the need for diabetics to exercise constant vigilance in regard to food, weight and glycemic control. In adolescent females, increased weight gain that insulin treatment can cause may increase the risk of anorexia and/or bulimia.