Definition of Diabulimia

''Diabulimia (Diabulimia is not a medical term but certainly used) is a combination of diabetes and bulimia. It is often seen in teenage girls with type 1 diabetes where insulin is omitted and food purged. Insulin is a growth hormone and weight gain can occur with really good control. This weight gain can be managed but teenagers become fearful and irrational about taking insulin. Their fear of weight gain from insulin is much like the fear of food and weight gain experienced by anorexics The combination of bulimia and diabetes is a dangerous and unfortunately for young people complications of diabetes arise a lot earlier due to damage caused from really high glucose levels. People are also at high risk of ketoacidosis and hypoglycemic episodes and coma.

People suffering with type 1 diabetes and anorexia have the double whammy of being fearful of both insulin and food. Starving the body of food and insulin is a very dangerous combination and a really difficult condition to get on top of. Weight losses are significant with the omission of insulin and the risk of ketoacidosis and coma is very high. The long term complications of malnutrition from not eating are worsened by the omission of insulin leading to the early onset of diabetic complications.''


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I also found this:

Women with type 1 diabetes are more than twice as likely to develop an eating disorder than age-matched women without diabetes.

Eating disorders in type 1 diabetes such as "diabulimia," as it is known in the popular press, represent some of the most complex patient problems—both medically and psychologically.

Women with eating disorders and diabetes typically struggle with symptoms similar to those of women with eating disorders who do not have diabetes.  However, they exhibit a very dangerous symptom of calorie purging in the form of insulin restriction.

This condition is characterized by weight and body image concerns that lead to the mismanagement of diabetes. 

Recognize eating disorders in diabetes

Warning signs may include:

• unexplained elevations in A1C values
• repeated problems with diabetic ketoacidosis (DKA), which can be fatal
• extreme concerns about weight and body shape
• change in eating patterns
• unusual patterns of intense exercise (sometimes associated with frequent hypoglycemia)
• amenorrhea (skipping monthly menstrual periods)

Understand the medical risks associated with eating disorders and diabetes

• higher A1C levels
• higher risk of developing infections
• more frequent episodes of DKA
• more frequent hospital and emergency room visits 
• higher rates and earlier onset of diabetes complications - nerve damage, eye disease, kidney disease and possible heart disease

The cycle of "diabulimia"

The cycle of negative feelings about body image, shape, and weight; chronically elevated blood glucose levels; depression, anxiety, and shame; and poor diabetes self-care and insulin restriction is difficult to treat:

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