DIABETES AND DIABULIMIA

Diabulimia is nevertheless a serious and emerging problem. Experts predict that as many as one-third of young female diabetics could be suffering as a result of this condition.

Diabulimia

Diabulimia is a term created to represent a condition of diabetic bulimia. The condition occurs when insulin-dependant diabetics skip injection in order to lose weight. This type of disorder usually affects type 1 diabetics. Young diabetics, who already have numerous issues to deal with, realise the potential weight loss possible by skipping insulin, without understanding how much they are damaging their bodies.

How does diabulimia work?






Diabetics who are reliant on insulin find that it is a storage hormone, and promotes fat. If patients miss injections, or manipulate dosage, they could theoretically reduce weight. Diabetics can continue to manage their disease, but neither safely nor effectively. Diabetic patients could avoid ketoacidosis and obvious signs of management failure, without realising the extent of damage that they are causing.

Why is it called Diabulimia?

The term, itself relatively recent, refers to a combination of diabetes and bulimia, a common eating disorder. In America, the phenomena is well known, and even recognised by the American Diabetes Association. Insulin omission is often seen in young girls.

Its affects on the body?


The side effects of manipulating and omitting insulin from the body can be serious and dangerous. Blood sugar levels can surge and reach an unhealthy level, leading to fatigue, dehydration and eventually wearing of the muscle tissue. Over a long-term, the symptoms are the same as badly managed diabetes. These can include complications such as retinopathy, neuropathy, kidney disease and further damage.

Treatment:










Diabulimia should be treated with psychological care and close monitoring.

* Cognitive-behavioural therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in tough situations.
* Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas.
* Drug therapy, such as antidepressants, may be helpful for some people.

Early prevention is key to avoid long-term damage to the diabetic patient.

Acknowledgement:

Diabetes.uk.in (M.Sc.,M.Phil.,PGDGC)
SEPH

B.ELAYARAJA (Counseling Psychologist & Asst Head)

COUNT YOUR

Mrs. Bhauvaneshvari
& Mrs. Sheela paul
Dietitian


Carbohydrates are the most important part of the food we eat. They directly affect your blood glucose almost immediately after you eat them. Carbohydrate counting, or "carb counting," is a meal planning technique for managing your blood glucose levels. Carbohydrate counting is important for all types of diabetes including type 1, type2, pre-diabetes and gestational diabetes. While maintaining a tolerable blood glucose levels, our body also need nutrients to function normally. Carbohydrate, protein and fat are the three main nutrients that give us energy. Carbohydrates are more easily converted into glucose compare to protein or fat.

There are generally two types of carbohydrates; simple carbohydrates (containing sugars like glucose and sucrose) and complex carbohydrates (containing fiber and starch). Simple carbohydrates raise blood glucose levels rapidly because their molecular structure breaks down faster in our stomach and small intestine. Complex carbohydrates, on the other hand take longer to be converted into glucose because their molecular structure is much more complicated. Every gram of carbohydrate that you consume provides 4 calories. A diabetic adult meal plan should provide 50-60% of carbohydrate from total calories.

Foods that contain carbohydrate will raise blood glucose. By keeping track of how many carbohydrates you eat, will help to keep your blood glucose levels in your target range. The right amount of carbohydrate depends on your gylcemic control, physical activity and medication. Each meal should contribute about 45-60 gm of carbohydrate. You may need more or less carbohydrate at meals depending on how you manage your diabetes.

Protein and Fat

With carbohydrate counting, it is easy to forget about the protein and fat in meals. Always include a source of protein and fat to balance out your meal. Carbohydrates in the diet have a direct effect on blood glucose levels. All foods that provide calories are converted into glucose by the body. While fats and proteins in a meal are eventually converted by the body into glucose to use for energy, carbohydrates (sugars and starches) are converted to blood glucose quickly- within an hour or so after a meal. Therefore, the level of glucose in the blood after a meal will be directly related to the amount of carbohydrate just eaten.



Carbohydrate counting is one of several methods of meal planning used by people with diabetes. This relatively new approach was one of the meal planning methods used in the Diabetes Control and Complications Trial (DCCT), and it is based on recent advances in the study of diabetes management.



Many people with type 2 diabetes are on oral medications to help them control their blood sugar. Some people can control their Type 2 diabetes with diet and exercise. Does that just mean eat good foods? Well, that is a part of it, but carbohydrates raise your blood sugar, not just sugar. Just because a food doesn't taste sweet, doesn't mean it won't raise your blood sugar. Exercise will usually lower it. If you are controlling your diabetes with diet and exercise, limiting your amount of carbohydrate intake can help control spikes in your blood sugar, and therefore help you to reduce your risk of complications, such as heart disease, amputation, and eye problems.

Insulin and exercise lower blood sugar, while carbohydrate raises it. Therefore, you want these things to balance to prevent hyper and hypoglycemia. If you are on an insulin pump, you tell the pump how many carbohydrates you are going to eat and most pumps do the math to give you the right amount of insulin to match the carbohydrates. If your carbohydrate factor is set correctly, this usually works out well.

With gestational diabetes it's important to count carbohydrates because you want to consume enough carbohydrates to help your baby optimally, but you need to control spikes in your blood sugar too.

With pre-diabetes carbohydrate counting is important because it can help slow the progression to full-fledged diabetes.

Diabetes is a progressive disease. The further you are along this path, the harder glucose control becomes, and the more careful you need to be with your carbohydrate counting for success. Counting carbohydrates is part science and part art.



Reading food labels is a great way to know how much carbohydrate is in a food. For foods that do not have a label, you have to estimate how much carbohydrate is in it. Keeping general serving sizes in mind will help you estimate how much carbohydrate you are eating.



For most people with diabetes, Carbohydrate Counting is a more flexible and simple alternative to the Exchange System. The goal is to make sure you're eating a fairly consistent amount of carbohydrate each day, in a similar pattern.

A word of caution: while counting carbohydrates can help manage blood glucose levels, it can also lead to weight gain if the fat and protein contents of foods are ignored. A lot of foods contain both carbohydrate and fat, such as many desserts, which will dramatically increase the calorie content of your food choices and could lead to weight gain. A medium banana and a chocolate candy bar both contain about 30 grams of carbohydrate, but the chocolate bar also contains an extra 15 grams of fat and 150 calories!

1 serving = 15gm of CHO


NOTE: 1 CUP MEASURE 150 ML

The final word on carbohydrate counting

Counting carbohydrates allows flexibility in your meal plan, but you can't abandon your meal plan and eat as many carbohydrates as you desire. Keep in mind your overall goals--to keep your carb intake at a certain amount each day, and keep your glucose as close to normal as possible--and you'll do well. Remember to consult your healthcare team before making any of the changes discussed here.