Weight conscious diabetics warned of danger in skipping their insulin shots

By Melanie Swan

Diabetics are endangering their health by not taking insulin shots or using low doses in a bid to avoid gaining weight, experts warn.
With about one million new cases of the condition reported last year, according to the International Diabetes Federation, the UAE has one of the world’s highest concentrations.
Clinicians have reported cases of diabetes bulimia in some younger patients who risk their health in order to prevent putting on the extra pounds that can accompany insulin use.

GP Dr Shereen Habib said "dia-bulimia" tended to happen more often with teenagers.
"I think it is important to make doctors, and more importantly parents of teenage diabetics, aware of this. It is probably more prevalent than we realise."

Noor Ramahi "battled for years" with dia-bulimia.

"Living with diabetes is a struggle and insulin makes you gain weight as it stores fat. Sometimes even when eating restricted calories you can still gain weight, especially if you are insulin resistant.

"I was diagnosed at the age of five and very early on was aware of carb counts, calories, fat in food, and the effects of insulin on the body. My maturity beyond my years was also my enemy because I was also smart at hiding my dia-bulimia and lying about it. I knew how to manipulate the system," said Ms Ramahi.
"Thankfully, I have reached a point where I have finally came to appreciate my body and everything it does to keep me alive, although I still deal with self esteem issues and do struggle with weight issues," said the Emirati who is now a mother of twins.
The 28-year old said that her family saw what was happening to her but did not know how to intervene.
"In the UAE, we do a good job at dealing with the technicality of diabetes but unfortunately don’t have a strong support system, groups, meet-ups or mental health clinics to deal with issues that arise from having this chronic disease," she said.
"Having a chronic disease is a 24/7 job. There are no breaks, no time outs, no vacations. It’s always there lurking in the shadows and that takes a toll on you," said Ms Ramahi.

Dr Thoraiya Khalfani, clinical director at Human Relations Institute, said awareness of the condition must be raised among health professionals.
"Those suffering with dia-bulimia withdraw from medication not to harm themselves, but to refrain from gaining weight and increase weight loss," she said, adding that this was often an attempt at gaining a sense of control.
"Eating disorders like bulimia and anorexia are very complicated and cannot be minimised."

When it came to seeking help, Ms Al Ramahi said she felt a lack of support and understanding.
"Dealing with an eating disorder is a mental disorder, it is a sickness in itself and it’s the healthcare team’s job to see the signs and intervene."
One of the key characteristics of an eating disorder is a drive for thinness, fat phobia, and disproportionate amount of concern attached to body weight and shape, said psychologist Dr Justin Thomas.

"These factors can become strong and all-consuming enough to make a person even forsake their diabetes medication," he said.
"In addition to restricting food, vital medication is skipped. In addition to compensating for overeating through exercise, laxative abuse or vomiting, not taking diabetes medication has become another, particularly dangerous weight or shape control technique."

http://www.thenational.ae/uae/health/weight-conscious-diabetics-warned-of-danger-in-skipping-their-insulin-shots