healthnut

For those on Buddyslim who are diabetics, here’s one weight loss method you should not attempt to do–skipping your insulin to lose weight faster.

“She calls it black magic. Every time her jeans start feeling tight, she skips a few doses of the insulin she needs to treat her diabetes. The pounds slip off - but there’s a price.”

“Damage from her uncontrolled diabetes is ravaging her stomach and her eyes. She was hospitalized three times in December and January when her blood became dangerously acidic.”

” Up to one-third of women with Type 1 diabetes skip or skimp on insulin doses in a dangerous attempt to lose weight, according to several studies conducted over the past decade. New research from the Joslin Diabetes Center suggests that women who skimp on insulin for any reason are more likely to suffer kidney trouble and foot problems - and more likely to die at a young age. Other studies have found higher rates of eye and nerve damage.”

“Medical professionals say it’s a sad irony that the very drug that can help a diabetic live a long, healthy life can also be abused to lose weight. People who don’t have enough insulin drop pounds because their bodies can’t absorb the nutrients in food and so pass them out in urine. “

http://www.chicagotribune.com/news/nationworld/chi-080331-diabetics-weight-insulin,1,7097811.story

Diabetics skipping insulin to lose weight—at a price

By Alice Dembner

Boston Globe

4:19 PM CDT, March 31, 2008

She calls it black magic. Every time her jeans start feeling tight, she skips a few doses of the insulin she needs to treat her diabetes. The pounds slip off - but there’s a price.

Damage from her uncontrolled diabetes is ravaging her stomach and her eyes. She was hospitalized three times in December and January when her blood became dangerously acidic.

“I was disturbingly amused about how much weight I could possibly lose even though I was killing myself,” said the 37-year-old Marlborough, Mass. woman, who developed Type 1 diabetes after the births of her three girls. She asked that her name be kept private in part out of shame about her continued insulin manipulation.

Up to one-third of women with Type 1 diabetes skip or skimp on insulin doses in a dangerous attempt to lose weight, according to several studies conducted over the past decade. New research from the Joslin Diabetes Center suggests that women who skimp on insulin for any reason are more likely to suffer kidney trouble and foot problems - and more likely to die at a young age. Other studies have found higher rates of eye and nerve damage.

“We know that women in Western cultures are willing to do quite dramatic and drastic things to effect weight loss. In the context of something as complex as diabetes, it has the potential to have grave results,” said Ann Goebel-Fabbri, the Joslin psychologist who was the lead author of the new study.

The Joslin researchers tracked down 234 women with Type 1 diabetes who had participated in another study in the early 1990s. As part of the first study, the women completed surveys about aspects of their behavior, including whether they took less insulin than they should. Thirty percent of the women in the early survey said they had skimped on insulin at some point.

In the follow-up study, the researchers examined deaths and diabetic complications that had occurred since then. They found 10 deaths among women who had restricted insulin, compared to 16 among the larger group who had not. Those who restricted their insulin died on average 13 years younger - at 45, compared to 58.

“The risk becomes greater once ((insulin restriction)) becomes more entrenched and more of a pattern,” said Goebel-Fabbri.

Several other studies have found higher rates of eating disorders in women with Type 1 diabetes than in other women. Type 1 diabetes typically begins at a young age when the body stops producing the insulin needed to turn food into fuel. There are no studies of insulin restriction in Type 2 diabetics, who still produce some insulin and therefore less commonly need the drug.

Good diabetes care can intensify eating disorders, particularly the focus on food selection and portions, and the strict control of blood sugar with insulin that can lead to weight gain as patients struggle to balance food intake and insulin.

Medical professionals say it’s a sad irony that the very drug that can help a diabetic live a long, healthy life can also be abused to lose weight. People who don’t have enough insulin drop pounds because their bodies can’t absorb the nutrients in food and so pass them out in urine.

The number of patients who don’t take all their insulin is much higher than most physicians are aware of, said Dr. Paul Strumph, chief medical officer for the Juvenile Diabetes Research Foundation. Some people may skimp on insulin not to lose weight, but because they find their insulin regimen too complicated or they fear lowering their blood sugar too much, which can also cause serious problems.

Yet, he called the study “a wake-up call” to doctors, signaling that they need to talk to their diabetic patients about the dangers of insulin restriction, and in particular, “whether … it’s worth it to be thin and not reach your 40th birthday.”

Jacqueline Jean Walsh died a week before her 28th birthday in 2004, after what her mother now believes was years of deliberate insulin underdosing. Walsh was one of the women in the Joslin study.

Diagnosed with diabetes at age 13, Walsh began struggling with her insulin regimen while in high school in Westford. Over the next decade, after she and her family moved to Utah, she was hospitalized repeatedly for serious complications of high blood sugar, according to her mother, Jacqueline Lyons.

Lyons knew there were times when “JJ” didn’t take her insulin, but it wasn’t until after her daughter’s death that Lyons discovered diaries that laid out a pattern of skipping doses to lose weight.

“JJ was never … overweight,” said Lyons, who lives in Acton. “But she felt fat” and she wrote in her diaries about a pattern of binging on sweets and then avoiding insulin to purge the calories. As she did that, she began wasting away, forced to quit work and forgo college. Eventually, her mother said, “diabetes beat up her body so badly that she stopped breathing.”

Lyons is speaking out to warn other women. “We need to tell them to stop,” she said. “You will die, and it will be a slow and painful death.”

Future advances in diabetes treatment may help some people, Strumph said. For example, new drugs may allow people to attain near normal blood sugar levels with much less insulin, and automatic systems could monitor sugar and deliver insulin doses without the patient’s involvement.

What is also needed, said Goebel-Fabbri, are better ways to screen for the problem, particularly among women who may hide their behavior, and research on how best to treat it.

The 37-year-old Marlborough mother of three is eager for additional help. She sees a psychiatrist weekly for problems that include depression, and attended an eating disorders program for a while. But she hasn’t been able to stop manipulating her insulin.

She’s had body-image issues her whole life, feeling huge although friends tell her she looks fit. After her diabetes was diagnosed in 2001, she began binging and purging - starving herself, then going into a feeding frenzy followed by vomiting or avoiding insulin. There are stretches of days now when she takes all her insulin, but when the pounds creep back, she starts cutting corners.

At times, her average blood sugar level has soared to 19, triple the normal level, landing her in the hospital. Now, the medical complications are piling up. She has swelling and fluid leakage in her eyes, and her doctors say she may go blind in a few years. She often can’t keep down food or liquid because of nerve damage to her digestive system. Her kidneys are showing wear.

“I have skirted death a couple of times,” she said. “I’m hopeful there is some treatment that’s going to click.”

“My driving force is not wanting to be a burden on my kids.”