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212 Cardio Diabetes Medicine 2017

Eating Disorders in Diabetes Mellitus

Dr. Davis Prabhakar, M.D (General Medicine)
Assistant Professor, Dept of General Medicine, Thoothukudi Govt.
Medical College and Hospital,
Consultant Physician, Ebenezer Hospital, Tuticorin

Abstract Why do people with diabetes get eating
A verse from the bible says” A man is not defiled by disorders?
what enters his mouth, but by what comes out It has been established that eating disorders includ-
of it.”(matthew15:11), yes!! In today’s modern era of ing anorexia, bulimia and EDNOS (eating disorder
medicine, the field of diabetology has taken the po- not otherwise specified) arise twice as often in ado-
sition of the fore runner among all the co-morbidities lescent females with diabetes as in the normal ado-
that causes mortality regardless of age and gender. lescent population. There are a number of probable
The emphasis on the ‘Golden triad’ of nutritious Diet, reasons for this phenomenon. First, when a child or
regular exercise and prescribed medication has al- adolescent is diagnosed with diabetes, they have
ways been repeatedly echoed in every diabetologists usually lost a significant amount of weight. This is
consulting chamber. because, in uncontrolled diabetes. When treatment

There is concrete evidence that exercise and medica- with insulin commences, there is normally a weight
tion when properly practiced do have a very import- gain. If a young person is vulnerable to an eating
ant role in controlling the glycemic status, in turn re- disorder,they may find this body change difficult to
warding the practicing diabetologist with laurels and deal with and may develop unhealthy strategies to
honours about his skill in treatment ,however when lose weight.
the expected glycemic control is not attained despite Secondly, there is a unique method of controlling
religiously following the golden triad, the blame is weight available to the diabetic young person. By
ridiculously blamed on Diet. This write up throws light “under-dosing” with insulin, or failing to take insulin
on this scenario and also the associated eating pat- at all, a state of high blood glucose – equivalent to
terns and disorders with diabetes. having uncontrolled diabetes – is induced, leading to
TEXT:- Diabetes mellitus is characterized by chronic weight loss. Within the context of an eating disorder,
hyperglycaemia and its incidence is rising rapidly in this can be considered to be a form of “purging”.
parallel with the obesity epidemic. Disordered eating, Thirdly, young people with diabetes are obliged to
especially sub-threshold eating disorders, is a com- engage with a self-care strategy which includes a
mon psychological problem in both type 1 and type 2 restrictive meal plan. Those with a predisposition to
diabetes, and Is associated with poor diabetes con- become obsessive about calorie counting may be at
trol, complications, and an increased mortality rate. greater risk of developing an eating disorder as a
Eating problems tend to co-exist with other psycho- diabetic. Furthermore, many diabetic clinics counsel
logical difficulties, especially depression and anxiety strongly against weight gain – advice which may be
disorders. taken to the extreme by some vulnerable teenagers.
In statically reviewed analysis eating disorders as- Finally, the effects of being diagnosed with a chronic
sociated with diabetes has been on a rising trend illness on a young person cannot be underestimated:
globally and reports suggests that the prevalence is it may be enough to push those already predisposed
high as 41.8% in Mexico, 22.1% in Brazil, 22.0% in to developing any mental illness over the clinical
India, and 19.3% in Argentina. threshold.

GCDC 2017