I need help

i need help

 

A lot of people with diabetes have a hard time with body image, disordered eating, or eating disorders. How do you know if you have a problem, and what can you do about it? DEDA has put together a few ideas to help you figure it out. So, let’s get started!

Do you need help?

Do you think you have a problem DEDA can help you with? Sruggling with your mood and food but not sure what to do about it? Take our quiz to find out

Here’s a checklist of 10 common behaviours in people with diabetes and disordered eating, diabulimia, or an eating disorder. Do any of them sound familiar?

Your treatment

your healthcare team

Your healthcare team might include the following people:

  • GP: Sometimes called a family doctor, a GP looks after your general health and can refer on to specialists
  • Endocrinologist or Diabetologist: Your diabetes specialist doctor
  • Diabetes Specialist Nurse or Educator
  • Dietitian: You might see a diabetes dietitian, an eating disorders dietitian, or both. They will help you with meal plans, carb counting, and help you develop a regular, balanced food plan to suit you
  • Mental Health Specialist Nurse
  • Psychiatrist: A specialist doctor who is trained to diagnose and treat mental health problems.
  • Psychologist: Someone who is specially trained to help people cope with problems and mental health issues

 

Your team is there to help you, so it’s important to be as honest as you can.

medication

Sometimes the chemicals in our brain become out of balance and medications can help restore this balance again. Taking medication does not mean you are weak or crazy, but can help your brain think clearly so you can work on coming up with strategies to help you cope with unpleasant emotions.

Some examples of types of medications sometimes used in the treatment of eating disorders or other mental health disorders might include:

  • Antidepressants for depression
  • Anxiolytics for anxiety
  • Mood stabilisers to help with intense mood shifts
  • Fluids and/or nutritional therapy to help with electrolyte imbalances, dehydration and malnutrition

 

You have the right to be fully informed about any medication prescribed to you. For straight talk on mental health medications, click here

(Adapted from reference 1, 3)

hospitalisation

Your health care team may decide with you that a stay in hospital may be the safest option for you. This may be related to your blood sugar levels, your physical or emotional well being. Going to hospital does not mean you are a failure. Hospitals can be lonely and boring, but it means that you are getting the help that you need at the time.

If insulin omission is part of your eating disorder, it can lead to a very dangerous condition called Diabetic Ketoacidosis (DKA). DKA results from a lack of insulin circulating around your body, and is potentially fatal if left untreated. Signs and Symptoms of DKA may include:

  • Extreme thirst and urination
  • High blood glucose and ketone levels
  • Feeling tired
  • Nausea/vomiting
  • Abdominal pain
  • Trouble breathing

It is very important to get help from your diabetes team or attend your closest Emergency Room if you think you have DKA.

(Adapted from reference 4)

deda's tips and stories

be stubbornly hopeful

  •  As long as you have air in your lungs, there is hope. Even if you don’t have hope, we at DEDA have hope for you – don’t ever give up!
  • Don’t let ANYONE tell you it’s impossible to recover
  • Remember that other people with type 1 diabetes and eating disorders have conquered it, and recovery is possible. You are never alone
  • Recovery is made up of thousands of tiny steps. Does it feel like you will never get better? Put one foot in front of the other. One meal at a time, one insulin dose at a time

be kind to yourself

  • Recovery from an eating disorder is hard work, especially with diabetes. Try to take time out for yourself to relax
  • Celebrate every small step you take
  • Pick out an activity you enjoy doing and find time for it every day
  • Remember it is not your fault you have an eating disorder and diabetes, and that recovery is possible
  • Instead of beating yourself up when you slip, remember that tomorrow is a new day. ‘Slip ups’ are not unusual in recovery and they are a chance to learn about triggers and uncomfortable situations
  • You are never past the point of no return. It’s never too late to start recovery

connect with others

Talk, talk, talk. Sharing what is going on is the best way to be honest with yourself and your team so you can start getting better. Admitting the truth can be scary, so if you want to talk to someone about what is going on with you, contact us here or go to deda’s Facebook page. You can also connect to us through our Blog, Instagram or Twitter. Friends and family can be a great source of help and a health care professional can help start connecting you with the right people to get you the help you need. You can also use the form below to contact us.

care for your diabetes

If you have diabulimia or any eating disorder, or if you are feeling low in mood, diabetes might be the last thing you want to take care of. It can be hard to find the motivation  and energy to get through each day, let alone to test your glucose levels, take your insulin, attend appointments, deal with hypos, or any of the other daily pressures of diabetes.

  • Ask for help from us at DEDA, your friends, family, support people, and health care team. Even though you do all the hard work, we are all here to support you and share the burden of the eating disorder and diabetes
  • Be honest with your diabetes team about how you are feeling
  • Set small goals with your diabetes team as you work towards getting better. For example, gradually increasing the amount of blood glucose testing you do if appropriate, adding in extra insulin if you have diabulimia , or even aiming to attend your appointments and receive the help available.
  •  Remember that numbers are just guides – you are more than just a number: You are more important than the number on your glucose meter, how much you weigh, how many carbs in your lunch, your HbA1c 

tackle the eating disorder

  •  If you haven’t already, ask for a referral to your local mental health team or psychologist if there is one available- preferably one who has experience with eating disorders
  • Work with your health care team to figure out your triggers
  • Make a list of things you can do to distract yourself when you feel triggered
  • Try and eat regularly. Hunger can make eating disorder symptoms worse
  • Having a meal plan can help you stick to a regular eating schedule- a dietitian can help you with this
  • Set small goals and reward yourself when you achieve them
  • Try and start to recognise the eating disorder thoughts, and challenge them with truth as much as you possibly can
  • Work with your team to try and find ways to cope with difficult feelings rather than act on destructive thoughts
  • Find someone you can be honest with when you are struggling with eating disorder thoughts

a letter of encouragement from deda’s founder

“When you are at your weakest, I will fight with you. When you don’t have hope anymore, I will have hope for you. When you see no point in living, be reminded of your incredible worth. Keep searching until you find what you are looking for. Don’t settle for less than what you deserve…”

real life stories

*Some names may be changed to protect identity

zoe, new zealand

Anorexia and Diabetes

“I remember the day so clearly when someone first found out about my eating disorder.  I was at netball nationals and we had just finished a big “pre-feed” the night before tournament started.  I made my way to the bathroom, the furthest from the dining hall and stared throwing up…”

Sarah*, New Zealand

Overcoming Bulimia and Diabulimia

“I was diagnosed with diabetes as a toddler, and my life was ruled by numbers and food ever since. Food, weight and body obsession was a way of life. It gradually worsened until I met the full diagnostic criteria for bulimia. I didn’t know I had an eating disorder. No one would have guessed…”

Claire*, Australia

Bulimia and Diabetes: A Double Whammy

“I was diagnosed with type 1 diabetes in March 2010, two months before my eighteenth birthday. However, I have struggled with an eating disorder (mostly bulimia) since I was around ten years old, due to a multitude of factors stemming from childhood events…”

Rachel, Australia

Why I Chose Recovery 

“I was diagnosed with Type 1 Diabetes when I was eleven years old and have struggled with ED-DMT1 or “diabulimia” as it’s more commonly known, and bulimia for the last thirteen years…I’ve written a list of reasons why I chose recovery. I hope it helps you find YOUR reasons to recover, because it is worth it and there is hope.”

Resources

books

Emotional Eating With Diabetes (Ginger Vieira)

Diabulimia: Towards Understanding, Recognition, and Healing (Aarti

Sharma)

Diabetes and wellbeing (Dr. Jen Nash)

apps

Mood Tools (Tools to help with depression)

Rise Up + Recover (Eating Disorder Recovery)

Recovery Record (Eating Disorder Recovery)

Beating the Blues (Requires referral from GP- for anxiety and depression)

Mindshift (Tools for dealing with anxiety)

Smiling Mind (Tools for dealing with stress)

Happier (A fun social gratitude journal)

Paced Breathing (Tools to aid relaxation)

Headspace (Mindfulness)

references
1. Anorexia Nervosa and Related Eating Disorders (2011). Diabetes and eating disorders. Retrieved from http://www.anred.com/diab.html

2. Deiana, V., Diana, E., Pinna, F., Atzeni, M., Medda, F., Manca, D., & Carpiniello, B. (2016). Clinical features in insulin-treated diabetes with comorbid diabulimia, disordered eating behaviors and eating disorders. European Psychiatry33(8) doi:10.1016/j.eurpsy.2016.01.029

3. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

4. American Diabetes Association (2015). What are the warning signs of DKA?  Retrieved from http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html

5. Zuijdwijk, C., Pardy, S., Dowden, J., Dominic, A., Bridger, T., & Newhook, L. (2014). The mSCOFF for screening disordered eating in pediatric type 1 diabetes. Diabetes Care, 37(2), 26-27

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