I struggled with disordered eating and risked my health by restricting my insulin (Picture: Eleanor Noyce)
Content warning: This piece discusses disordered eating
I was diagnosed with Type 1 diabetes six years ago, at 17.
Preparing for my AS Levels in the spring, I was experiencing fatigue, extreme thirst, aches and pains, and sudden, unexplained weight loss.
After three weeks, I went to the doctor. The excess glucose from extremely high blood sugars had clearly amassed on my tongue, and I was sent away with medication for oral thrush.
Over the months before my diagnosis, I lost around two stone. Undiagnosed diabetes often triggers extreme weight loss: without insulin, the energy from food cannot be processed, and the pounds practically fell off me.
Friends and family complimented me on how ‘good’ I looked, asking which diet I was on. My formerly size-14 self quickly shrunk to a size 10, and I basked in this new-found validation – but I didn’t feel confident. Something wasn’t quite right.
For months, I accepted that this mystery illness of mine would never be cured: that is, until my mother marched me into the doctor’s surgery in August 2015, four months after I initially sought medical help, and demanded that my blood sugar be tested.
I was immediately sent to the hospital, and I remember wondering whether I would even make it in time. It was one of those rare moments in life that not many experience: a tiny voice in my head asked: ‘Am I going to die?’
I knew that if the doctor was correct, and I was Type 1, I would have been without insulin for four months. The prognosis for undiagnosed Type 1s isn’t good. At this point, I was lucky I wasn’t comatose.
Surrounded by screaming toddlers in the paediatric wing, I felt out of place: I was months away from my 18th birthday after all. There were numerous checks with little explanation as to what was going on, and eventually I asked: ‘Do I have Type 1 diabetes, then?’. I was told, ‘Well, yes’.
Since then, my journey towards control of my blood glucose levels has been tumultuous, to say the least. My diabetes has caused my weight to oscillate between nine and 13 stone.
Type 1 diabetics are very sensitive to weight fluctuation. I’m now at a comfortable weight and I’ve settled into healthier eating habits, but it wasn’t always this way.
Diabulimia is an eating disorder where people with Type 1 diabetes restrict their insulin doses to lose weight. Largely neglected in the discourse surrounding eating disorders, it is estimated that about four in 10 diabetic women between the ages of 15 and 30 purposefully take less insulin to lose weight.
The potential long-term health complications associated with this kind of poor glucose control are vast, including glaucoma, kidney disease and foot ulcers.
I’m now at a comfortable weight and I’ve settled into healthier eating habits, but it wasn’t always this way (Picture: Eleanor Noyce)
A year after my diagnosis, I moved to university – which meant it was easier than ever to drink and eat as I pleased. I had come equipped with a newly issued insulin pump, which gave me much more control over my intake of insulin.
Before, I’d been manually injecting myself when I ate: it wasn’t as easy to eat dinner and then spontaneously decide to have a snack. Injections required more planning, but now all I had to do was press a button.
For the first time since my diagnosis, I felt closer to my old, ‘normal’ life.
I quickly got into the habit of visiting the local Tesco whenever I had a sugar craving – which was just about every evening. I’d come home with a few bags of whatever was on offer and devour it all in secret.
I didn’t want my flatmates to get the impression that I was a ‘bad’ diabetic, and I also didn’t want to be perceived as ‘piggish’ or ‘greedy’, so I kept it to myself.
Eventually, I got to the point where I was noticeably putting on weight. I quickly became insulin resistant, and the more carbs I was eating, the more insulin I needed.
My increasing weight facilitated this resistance, as a higher body mass necessitates higher dosages as it struggles to absorb insulin efficiently. I was going through insulin pumps at a rate of one a day, when they’re meant to last for three.
It is estimated that about four in 10 diabetic women between the ages of 15 and 30 purposefully take less insulin to lose weight
I was prescribed Metformin to treat this, but I was already caught in an endless cycle of snacking, putting on weight, and then upping my insulin dosages. I became inactive and depressed. Hating myself and my body, I wanted to be left in my room in peace, free from judgment.
I could see how concerned my friends and family were – and I understood their worries. Just one year before, I’d hit the lowest weight I’d ever been. Now, I looked like a completely different person.
As my weight increased, it became tempting to deliberately take less insulin than I needed. I was struggling with fresher-related weight issues often referred to as the ‘fresher 15’, as well as my disordered relationship with insulin and eating.
‘Why not play around with my intake a little?’, I thought. I knew the risks, but I was so desperate to return to that unhealthily skinny version of myself I’d reached before diagnosis that I didn’t care.
My blood sugars sky-rocketed most days. Diabetic ketoacidosis or DKA, which occurs as the body starts running out of insulin, resulting in the development of harmful ketones, was a real possibility: many Type 1s end up comatose, or worse, from this condition.
I still struggle with my body image, but I don’t restrict my insulin (Picture: Eleanor Noyce)
I would tread a fine line, never cutting out my insulin entirely (which meant I wouldn’t qualify for an official diagnosis of diabulimia) and still keeping my insulin pump on, but sneakily decreasing doses where I could.
No one noticed, and I doubt it even made much difference to my weight, but it was the mentality that was damaging.
Eventually, I reached a point where I knew that something needed to change. My 17-year-old self, sitting in that hospital bed, would have been appalled: when I was first diagnosed, I was strict with glucose control. My health was more important than anything else – how could I abuse myself in this way?
I never revealed my struggles to a healthcare professional, but I wish I had. I was in denial, ignoring the realities of what insulin restriction can do to a body. It’s taken me years to get to the point of realisation I’m at now, and I still have moments where I’m tempted to skip a dose if I’m feeling chubby.
I still struggle with my body image, but I don’t restrict my insulin. My diabetic body has been through so much: it’s only right that I take care of it.
Recently, I had a bit of a blip. My insulin ratios needed adjusting as the stress of my final year was wreaking havoc with my glucose levels, and I was going through insulin pumps at a quicker rate.
This was triggering for me, reminding me of the weight I put on back in my first year. The thought of gaining weight panicked me, and it brought me back to being told off by my doctor for poor control.
I’ve since blocked out the panic at the thought of gaining weight, and my monitor tells me that this week I’ve been in range almost 90% of the time, compared to 30% on my worst days.
I’ve focused on my running, and I can now run up to 13km without stopping. Six years ago I never thought I’d be able to live a life as full as this.
At the age of 23, I’m at a comfortable place. The NHS has prescribed me with a monitoring system, which allows me to scan my blood glucose, and I wear my pump on my arm with pride. I’ve finally learnt my lesson: blood sugars are more important than body image.
If you suspect you, a family member or friend has an eating disorder, contact Beat on 0808 801 0677 or at [email protected], for information and advice on the best way to get appropriate treatment
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