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Islets of Hope disorders associated with diabetes |
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Article by Lahle Wolfe Sources: Something Fishy - Eating disorders and diabetes Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) Eating disorders in adolescents with type 1 diabetes; Robert P. Hoffman, MD. Women's Health Matters: Eating disorders in women with diabetes American Diabetes Assn. - Diabetes Spectrum; Diabetes and Eating Disorders ED - Section 1 ED - Section 3 Fast Click to Disorders Associated with Addison's Disease Fast Click to Problems Associated with Acanthosis Nigricans (AN) What is the most common eating disorder seen in women with diabetes? Bulimia (the binge and purge disorder) is the most common eating disorder in women with type 1 diabetes. For women with type 2 diabetes, binge eating is more common. Islet of Information Amazon Affiliate program book ad
Eating Disorder Support Organization Links Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED) National Eating Disorders Association
Overeaters Anonymous (OA) - OA is NOT a diet support group like Weight Watchers. OS is a 12-step support program for persons with eating dysfunctions and addictions. OA has about 6,500 meeting groups in over 50 countries. Overeaters Anonymous World Service Website Are you a compulsive overeater?
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Eating Disorders - Section 2 print this article Mini Site Index Famous People with Eating Disorders Section 2 Diagnostic Criteria for Anorexia Nervosa Anorexia is classified by several characteristics including being 15% or more under a normal body weight. Anorexics, which sometimes refer to themselves as “Annies,” are often perfectionists and people pleasers and may appear highly emotionally stable on the surface and are rarely seen as "problem" children. They may exercise frequently and eat very little food and are likely to misuse laxatives and enemas. At some point, women of childbearing age may stop menstruating and become hirsute (excessive growth and darkening of the hair, especially on the face). Brittle nails, from undernourishment may also be seen in those with anorexia. Diagnostic Criteria for Bulimia Bulimia is classified as being at a normal or near-normal body weight with periods of food binges usually, but not always, followed by some sort of purging activity. Bulimia is diagnosed when a person exhibits these behavior patterns two or more times a week over a 2-3 month period of time. Bulimic persons may refer to themselves as “Billies.” Note: Women with type 1 diabetes are more likely to suffer from bulimia than any other eat disorder. Some common traits seen in bulimia include:
Diagnostic Criteria for Binge Eating Binge eating is characterized by overeating in excessive, sometimes even dangerous quantities. The binge eater may or may not use purging activities and is typically overweight. Binge eating is almost always done in secret and may lead to elevated blood glucose levels even in nondiabetics. Note: Women with type 2 diabetes are more likely to suffer from binge eating disorders than from anorexia or bulimia. Some common traits in binge eating disorder are:
Control Issues: The Heart of the Matter It is important for parents of children with diabetes to be highly sensitive to the sudden loss of control children experience when diagnosed. This is not an imagined loss of control, but a literal one with life-threatening consequences for noncompliance. Children quickly understand that straying from the care path chosen for them can lead to parental anxiety, disappointment, and even anger. Almost overnight their entire world of choice is taken from them. Children, even from a very young age, are able to understand that to do things the wrong way with diabetes can kill them: control is essential. This is an adult burden even adults have trouble adjusting to. Children, while resilient, are not without the need to feel in control as well, but as much as they need and long for control over choices, they also may fear making those choices. Diabetes care can be more complex than rocket science and children need to learn to master their care one step at a time. Unfortunately, diabetes doesn’t permit that time, so a parent or caregiver must step in for the child. Children will either feel the burden of having to be “perfect” for their own sake or to ease their parent’s concerns, or, that they must relinquish total control, however reluctantly. Some children will fight parents openly and aggressively by exhibiting anger and defiance, but ultimately, it is because they sense control has been taken and they don’t know how to otherwise cope with the invisible illness they must now deal with every moment of the day. For those on insulin pumps, diabetes life can be a little simpler. Persons on pumps do not need to eat to feed the insulin and life is no longer lived on a schedule determined by shots. But that does not mean pumpers are not at risk too. Shot therapy, in my opinion, is brutal. It is hard on parents and hard on children. Not every child (or adult) is suited for life on an insulin pump and I don’t intend to imply everyone should run out and get pumped, but let’s face facts, with shots, you have to live on a much tighter schedule controlled by injections. Some children handle being “told” what to do by glucose reading and shots better than others do. If your child is refusing to eat, lying about eating, under bolusing, or not injecting at all, it is time to talk with a professional about counseling and maybe even about switching to another type of insulin therapy suck as pen-injections, Lantus (the “poor man’s pump), or even to an insulin pump. Your child’s behavior should not be punished or criticized; it should be taken as a message to be carefully considered, and then responded to, appropriately. How Parents Can Help Prevent Eating Disorders Learn Coping Skills. There are many things parents can do for children with diabetes to help them cope. The first is to actually teach them coping skills (see our “Stress Management for Children” section for more details). Living with a chronic disease is not easy and requires new emotional skills. Learn them yourself and teach them to your child. Give Back Control. Find ways to give your child control in lifestyle, food choices, activities, and other routines that are less important, such as bedtime, TV shows, or a new responsibility, or privilege. Obviously, you cannot turn care decisions over to a 5-year-old, but you can ease up on other areas in their little lives to help them feel more empowered by granting them reasonable self-governing decisions. The key to raising any child is respect and choosing your battles wisely. Diabetes is a big battle, but whether to sleep with the bedroom door opened or closed, and the yellow vs. the hot pink sweater with the orange and purple pants are not battles worth fighting. Be a Grownup. As the cold saying goes “put on your big girl panties and deal with it.” Reassure your child. Shelter them from your own anxieties. It may be okay to cry with them once in a while but it is never okay to cry on their shoulders. When Elizabeth is down about diabetes I confer with her and affirm her feelings, yeah, I say, diabetes sure stinks and it is not fair (Islets of Hope even has an online discussion group entitled Diabetes Stinks). But I never tell her she is lucky to be alive, or that her problems are not real. I tell her that her fears are to be talked about not just thought about because I will look after her and do the worrying for her. Ease Up. One of the hardest things I had to learn to do after Elizabeth was diagnosed was to stop telling her about all the things she could not do… “No, your sugars are high you cannot go out and ride your bike… no, you cannot have a sandwich, you need a marshmallow … no, you cannot sleep over at Sally’s house because who would test you in the middle of the night?" I was scared to death for her to the point I would not sleep at night but a few minutes at a time because “something” might happen. Elizabeth picked up on my anxiety as I became overprotective. She began echoing my unspoken fears and talked a lot about dying. She knew, without my saying it, what I was thinking by the way I controlled her entire life’s activities. Accentuate the Positive. To help her cope I began focusing on all the things she can do and hid my own worries better. I now have an entire stash of half a dozen fast sugars and she gets to choose which one she wants (her favorite is a marshmallow with a gumdrop and her least favorite is juice). We invited Sally over to our house (her mom wouldn’t let her come either; apparently, even nonD parents can be overprotective too). And as for the bike riding I suggest we play cards or cuddle with a book instead – not "until your sugars come down" but because I love her and she’s always happy to have my time and attention when it is focused on the positives. Get Counseling - Diabetes is something that affects the entire family not just the person diagnosed. Family counseling, or a support group may be beneficial in helping with the difficult emotional and logistical adjustments to families living with diabetes. Don't wait until there is a problem to look for support. Individual counseling for children or other family members who are having a hard time coping with diabetes can help the entire family. Sometimes, just having someone to talk to can be healing. (IOH has online support groups for siblings, parents, and even grandparents.) Join a Support Group - Approximately six months after Elizabeth was diagnosed (at age 4) with type 1, we attended our first support group meeting. It was wonderful to meet other families face-to-face. Elizabeth was delighted to be able to meet other children with diabetes and was reassured when she saw them running around like (nonD children) carefree as puppies. They children played and chatted, but not once did I hear them talking about diabetes. Somehow, the thing that seemed to bind the group of children transcended diabetes; just being with a group of peers where diabetes did not have to be explained to others seemed enough for Elizabeth. Having fun and making new friends seemed most important. When one child's pump alarm sounded an occlusion error, the kids made jokes about her "cell phone calling for Mom." The parents, however, talked almost exclusively about diabetes care, tips, humorous moments, and fears; something they needed most. If you are in, or near Upland, CA, please contact Lahle@isletsofhope.com and ask about IOH's San Bernardino area support group for pre-diabetes and diabetes types 1 and 2. Get Involved with Diabetes Activities in Your Community - The Juvenile Diabetes Research Foundation (JDRF) hosts many events throughout the country. They also have chapters and volunteer opportunities in every state. In October of 2005, our family participated in the "Walk for A Cure" event local to us. It was a profound experience being surrounded by so many affected by diabetes and to see so many without diabetes stand up to support a cure for me and my daughter (and everyone else with diabetes). Local events are a great place to feel proactive with a disease that sometimes leaves people feeling helpless, and to meet other families for future play dates, babysitting exchange services, and even to find out about schools, products, and services that are tailored for persons with diabetes. Large group events are a great way to help families feel connected and not so isolated. For more information about upcoming nationwide and local events, post your own group's event, or to learn how to start your own group, please visit out Events page. | |||||||||
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