Islets of Hope complications of diabetes
By Lahle Wolfe
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For concise, less technical information on diabetes and complications, please see our "Newly Diagnosed" section.
Weight Loss and Diabetes
Weight loss can be part of a healthy approach to managing diabetes, especially for those with type 2 diabetes. But when weight loss is either unintentional, rapid, or body weight is below an ideal range, it could be part of an underlying medical condition or possibly due to an eating disorder.
Weight loss can occur when blood glucose levels are too high, or, when those on insulin are not taking enough insulin to cover food eaten. One of the symptoms of type 1 diabetes prior to diagnosis is weight loss because when not enough insulin is present to properly metabolize and make use of food energy glucose (sugars) will build up in the blood stream, the body begins to starve and turns to its own fat reserves to for an alternative source of energy.
To understand why weight loss occurs when not enough insulin is present it may help to think of insulin as a key that "unlocks" cells and allows glucose (from food energy) to enter into cells and nourish the body. Without sufficient insulin the body's cells, tissues, organs, and even the brain begin to starve. As a defense, the body turns to fat stores in an effort to find useable energy. When this happens, in addition to a buildup of glucose in the bloodstream, ketones (a byproduct of fat burning) may also build up in the body. This can lead to a serious, potentially life-threatening condition called diabetic ketoacidosis (DKA) and may require hospitalization.
You should always discuss unexpected weight loss, or moderate-high levels of urine ketones to your physician.
Why should you know about eating disorders? If you, your child, or loved one has one of the many metabolic disorders that carry a medical demand of closely monitoring eating habits, there is a significant increase in the risk of developing an eating disorder. Eating disorders (EDs) are not just a problem for young girls; an all too common belief. EDs can develop at any age and also affect boys and men. In Australian type 1 diabetic children as young as 11 years old purposely under bolus insulin with meals in order to lose weight.
In the United States studies suggest up to 25% of all females with diabetes – a prevalence of 2-6 times higher in women with diabetes than in the general population – have an eating disorder. The findings from a study by Flinders Medical Centre in Adelaide, also showed children in Australia with diabetes were markedly affected by disordered eating behavior:
While diabetes does not actually cause an eating disorder, having to pay close attention to weight management and food choices places an unnatural and unhealthy focus on eating and leads to distortion of self and body image. Once a person has ED issues, it is often easy for them to hide their problem under the guise of “it is part of my diabetes care plan.”
Restricting, the elimination of certain foods or entire food groups, is a common factor in ED behavior, as is developing “safe” and “unsafe” food lists. A person may become overly concerned or anxious when offered something from their “restricted or unsafe list.” The initial limitation and focus of a food may stem from legitimate management issues (eating high glycemic index carbohydrates causes a rapid rise in blood sugars, fat prolongs highs) that develop into compulsive avoidance. Fear may also stem from weight gain which can happen with all forms of diabetes, and for diabetics, the body conscious, ultra-thin-is-desirable- culture we live in, is made even worse because diabetics are weighed at every visit and constantly reminded from a health standpoint about excess body weight and diabetes. And those with metabolic challenges, especially type 2 and pre-diabetes, hear the “thin message” from culture, health professionals, parents, and even their own still voice from within. In fact, many believe that diabetics are to blame for their onset and readily point the finger at a lifestyle out of control.
Page Updated 02/23/2006