Diabetes and bulimia are both well known medical conditions, but have you heard of diabulimia – a dangerous conflation of the two?

Yesterday, the BBC aired a documentary called Diabulimia: The World’s Most Dangerous Eating Disorder. Here’s everything you need to know about it…

What is it?

A nurse administers a diabetes test
A nurse administers a diabetes test (Peter Byrne/PA)

According to Jacqueline Allan, researcher at Birkbeck, University of London, diabulimia is: “The situation where somebody deliberately and regularly reduces the amount of insulin they take, due to concerns over their body weight and/or shape.”

It’s a combination of a physical and mental illness – the sufferer has both Type 1 diabetes (a disease which causes your blood sugar levels to rocket) and an eating disorder.

Diabetics need to take regular insulin shots to manage their blood sugar (glucose) levels, and it’s particularly dangerous if they don’t regulate this.

What happens if insulin isn’t properly taken?

This can lead to weight loss as the body begins to draw upon fat for energy.

If a diabetic doesn’t take the proper amounts of insulin, it can lead to hyperglycaemia – when glucose levels build up in the blood.

Allan says: “Hyperglycaemia leads to polyuria [going to the toilet lots]. This means that any calories taken in by eating are passed straight through and out of the body in the urine.

“As a result, the calories are not used and the body is starved of its source of energy – energy that’s needed for every organ to function.”

Long-term, untreated hyperglycaemia can lead to diabetic ketoacidosis (DKA). This is when the body looks elsewhere for energy sources and starts to break down other body tissue – which has the potential to be fatal.

Hyperglycaemia has a whole range of long-term dangers, including heart disease, loss of sight and kidney disease.

Why are people with diabetes more susceptible to eating disorders?

Research suggests that those with diabetes are more likely to suffer from an eating disorder.

Diabetes UK says that 40% of all women between the ages of 15-30 with Type 1 diabetes are affected by diabulimia. Other research also suggests that it’s not just female diabetics who are affected, but males too.

This could be down to the nature of diabetes – in order to manage the condition, the sufferer needs to be disciplined with what they eat and drink. Exercising strict control over your body and an almost obsessive focus on food are characteristics that can make a person vulnerable to an eating disorder.

In some cases, it is also thought to be a way of rebelling against their diabetes.

What is the BBC’s new documentary?

The documentary follows three young sufferers of diabulimia, who it says “are risking their eyesight, limbs, fertility and lives in order to be thin”.

It explores the mental health aspect of the condition, as well as lack of expertise in the healthcare community and the long-term effects diabulimia can have.

You can watch the programme online here.

How can sufferers get help?

Diabulimia is not a medically recognised condition, and even though healthcare providers are becoming more aware of it, there is still some way to go.

This is particularly important, as Allan writes: “Diabulimia requires careful treatment from a team of specialists.”

The charity Diabetics With Eating Disorders was set up to tackle this intersection of the two conditions, and its website is a good source of information.

If someone is potentially struggling with diabulimia, they should see their local GP or give the Diabetes Helpline a call on 0345 123 2399.