Finally, a serious look at Type 1 and eating disorders!

I was pretty excited when I saw this article in my alert today. Finally someone is researching … and proving … that Type 1 diabetics have a screwed up relationship with food. And, perhaps more importantly, it’s not all in our heads.

I’ve seen a lot of talk in the DOC lately about the relationship between Type 1 diabetes and eating disorders. Amy over at Diabetes Mine shared this great  guest post about a teenager and her mother who struggle together with the daughter’s diabulimia and Lee Ann at The Butter Compartment has been one of our strongest advocates when it comes to the psychological effects of this disease, especially eating disorders. Check out Lee Ann’s great collection of diabulimia interviews here and also her great collection of diabulima resources here.

But it was the details in this article that really caught my attention. The author points out that our forced obsession with food and excercise can cause us to loose perspective on healthy eating and exercise habits. But what was most interesting to me is that Type 1s have several physical obstacles to a healthy relationship with food as well. Finally, someone is validating our long held belief that this disease makes us hungry!

In particular, the article talks about the dysregulation of hunger-related hormones including amylin. Dr. Deborah Young-Hyman, a pediatric psychologist and her colleagues are doing research into the connection between disordered eating behavior and the dysregulation of these hormones. The article also points out that  insulin, the treatment for diabetes, increases hunger, especially when the dose is even slightly miscalculated and blood sugars are not stable.

And to think, since adolescence, my doctors have just shrugged off my comments that “I am always hungry. Always.”

In the article, Dr Young-Hyman is quoted as saying “We need to document that these patients are experiencing dysregulation in satiety and that it’s not only connected with factors one usually associates with disordered eating behaviors such as societal pressure, anxiety and depression … It’s also associated with having diabetes.”

Her hope is that such studies will lead to improved insulin delivery methods and new therapies that address the dysregulated hunger-related hormones.

Even if her studies only lead to a greater awareness of our struggles to tame this disease, struggles that are both psychological and physical, I would feel like it is a step in the right direction.

It is about time that the medical community starts to realize that we are up against a losing battle here. The struggle to maintain healthy blood sugar levels, a healthy emotional outlook, a healthy weight, and a healthy relationship with food is one that is nearly impossible to balance. It is never-ending and when we fail, the consequences are severe. Until this realization becomes mainstream, we will continue to struggle with sub-par treatment options and treatment goals that are not realistic.

Resources

Diabetes’ link to eating disorders explored on EurekAlerthttp://www.eurekalert.org/pub_releases/2010-03/mcog-dlt031110.php

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4 Comments on “Finally, a serious look at Type 1 and eating disorders!”

  1. Shannon Says:

    As someone who has struggled with Diabulimia in the past, and who constantly struggles with her weight, I am thankful to see that doctors are finally making the connection.

    Like you, I have found that I am always hungry, even after a satisfying meal. Amylin deficiency is a big problem, as more and more studies are showing. I recently started taking Symlin, and it’s really helping with my hunger (as well as my pesky BG spikes after meals).

    Who knows what else our dead beta cells are supposed to be doing?!?

  2. saffy Says:

    I hope you don’t mind, I’m going to link to this. The more people who know about this the better IMHO.

  3. Scott S Says:

    I was pleased when I saw this news alert in ScienceDaily this morning as well. The real issue is that doctors seem to be so used to blaming type 1 diabetes patients for everything including depression without taking a moment to consider 1) that there is a medical issue besides diabetes at work here and 2) that there’s little, if anything wrong with the treatment plan being prescribed. As “Showdown With Diabetes” author Deb Butterfield once wrote:

    “To succeed with intensive therapy a person must take three or more daily injections of insulin (or insulin pump therapy), four or more daily blood glucose tests, and follow dietary instructions. The principle underlying the belief that more diabetes education will improve a person’s ability and/or desire to practice intensive insulin therapy is grounded in the assumption that it is reasonable to expect a person to perform these acts every day for the rest of his or her life. At the beginning of 1998, the NIH published their final recommendations for the strategy that will guide their diabetes initiative. One of their recommendations to ‘achieve desirable outcomes’ is to ‘apply behavioral theories and strategies to maximize diabetes self-management’. Their recommendations are to ‘develop and evaluate strategies that address social and cultural barriers to adherence,’ and ‘to study interventions to decrease psychiatric and social co-morbidities in individuals with diabetes (for example, depression, eating disorders, and family dysfunction).’ … Perhaps the best test of these ‘behavioral theories and strategies’ would be to follow 1,441 non-diabetic people over a period of 10 years as they try to comply with the regimen of injections, restrictions and uncertainty that is expected of the diabetic population. The conclusion would, I’m sure, be that the regimen itself is unreasonable and that the co-morbidities of depression, eating disorders and family dysfunction are, after all, only human. The disparity between the findings of the DCCT and the continued escalation of secondary complications points to one undeniable truth—only a cure for diabetes can have any significant impact on the human toll the disease exacts.”

  4. Katie I. Says:

    Scott S hit the nail on the head, IMHO. I’m glad to see an article like this, but the whole subject makes me a little bummed because it just seems like there’s no way out… insulin is our only choice right now, and yes, you will gain weight if you take it so that your A1c is within an acceptable range. Sucks.


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