Typically, when a person who has diabetes type 1 or insulin-dependant diabetes has not yet been diagnosed, they will experience a range of symptoms including "unexplained" weight loss. To understand that symptom, you need to realize that when blood sugar levels consistently run higher because you are not producing sufficient (or any) insulin to help utilize the glucose, then the calories and glucose absorbed from food, literally dump into your urine and out of your body. That is why weight loss occurs as a symptom of diabetes type 1. You are simply not absorbing and utilzing the calories. Though a small subset of the population can be overweight and have type 1 diabetes, more typically being overweight is associated with type 2 diabetes, or mixed type 1 and type 2 diabetes. So naturally, as soon as a diagnosis of diabetes type 1 is made, and insulin is introduced to the patient, calories and glucose are now utilized more efficiently and weight gain will occur.
That's why, once blood sugar levels are stabilized with insulin, even type 1 diabetes requires dietary measures that help to stabilize weight. Along with counting carbs, the patient also needs to count calories so that after weight is stabilized they don't gain excess weight. Leave it to the teenager diagnosed with type 1 diabetes to realize, that if they want to lose weight, all they have to do is “stop using insulin.” Sounds crazy and it is quite dangerous, but it is also one of the more recent eating disorders to be identified. It’s called diabulimia and it often surfaces among teens with diabetes type 1 who are athletes, who are dating, who are preparing for prom – and who all want to lose weight. Stop using insulin and they find that they can drop pounds and a size or two with little effort. The problem is the risks associated with stopping insulin therapy. It can contribute to vision impairment over time and even blindness, kidney failure, compromised circulation and even gangrene, requiring limb amputation. People who stop insulin in order to lose weight can also experience nerve pain due to nerve damage.
But teens are a group obsessed with body image and weight, and the average teen will try all sorts of trendy diets and even dangerous diets to shed weight rapidly. So a teen with type 1 diabetes pretty much has that same mentality, and has the added advantage (I really hesitate to use that word here) of being able to stop insulin and almost always lose weight. Clearly even healthy teens who adopt dangerous diets to drop weight quickly can develop health issues like low blood pressure, dehydration and kidney stones, but the stakes are far greater and more ominous in a teen who has insulin dependent diabetes, and who decides that weight loss is more important than staying on their medications. If a teen is overweight and has diabetes type 1, the best solution is to seek help from her doctor and a dietician. A sensible eating and exercise plan that takes into account insulin needs is the only choice that’s safe and effective.
The takeaway message is that parents and health professionals, teachers too, need to be aware that all teens are at risk of developing eating disorders, especially if they do decide to diet away excess pounds. A healthy effort can easily turn into a dangerous health obsession. In a teen with type 1 diabetes, the dangers associated with an eating disorder like diabulimia, are even further amplified.