Diabulimia - page 2

wow watching the morning show on fox 2 about a couple young girls afflicted with diabulimia.. has anyone seen this before? i'm wondering how common it is.... Read More

  1. by   sirI
    Quote from woody62
    Type 1 and 2 are difficult for many sufferers to control. Combine Type one with the bulimia and it becomes triply hard to control. Unfortunately too many health care professionals provide the education then wash their hands if the patient fails to comply.

    Woody
    Most, if not all of my pts. with diabulimia, were Type 1.

    You are correct, woody. Because diabetes is such an overwhelmingly difficult dz process to manage, the healthcare provider can and often does become frustrated and at a loss for anything else to help the patient with diabetes. That's why it takes a group effort with many providers to educate and treat the patient - not rely solely upon the shoulders of a single provider.
  2. by   alkaleidi
    WOW.

    Last night in the ED I got a 16 yr old girl who's sx's were nausea/vomiting for about 18hrs. Only history was diabetes. Mom was worried she was pregnant, but while the patient was out of the room mentioned that her daughter had also lost a significant amount of weight over the past couple months.

    I thought it was weird that she had a ridiculous amount of ketones in her urine, and her specific gravity was on the crazy side of dehydrated. With a previous behavioral health background, a lot with eating disorders, I instantly thought "bulimia" but thought it was weird for that to be paired with diabetes.

    Coincidental reading this post -- thanks for the heads up -- I wonder if this was what was going on!
  3. by   woody62
    Quote from sirI
    Most, if not all of my pts. with diabulimia, were Type 1.

    You are correct, woody. Because diabetes is such an overwhelmingly difficult dz process to manage, the healthcare provider can and often does become frustrated and at a loss for anything else to help the patient with diabetes. That's why it takes a group effort with many providers to educate and treat the patient - not rely solely upon the shoulders of a single provider.
    My L***, I don't believe it. Ahealthcare professional that actually believes it is a group effort. I also hope that you realize that with many of the Type 2's, that are many other problems that can impact on their compliance with diet, exercise and medication. And that these problems need to be addressed as well, in the course of educating the patient, or their compliance may fail.

    Woody
  4. by   sirI
    Quote from woody62
    my l***, i don't believe it. ahealthcare professional that actually believes it is a group effort. i also hope that you realize that with many of the type 2's, that are many other problems that can impact on their compliance with diet, exercise and medication. and that these problems need to be addressed as well, in the course of educating the patient, or their compliance may fail.

    woody
    off-topic:

    yes, i do. financial concerns primarily are huge issues. many......way too many are constrained due to these concerns. many other issues come into play as well and of course, this isn't the thread to address these issues.

    but, i do attempt to address these issues/concerns when dealing with the complete person. to not do so is doing damage to the patient and their healthcare.
  5. by   daisey_may
    I had not heard of this before, but unfortunately I'm not surprised. My heart goes out for these patients though because I'm sure other problems exist--or soon will, even with education. It's frustrating enough sometimes trying to teach someone with DM I or II about the importance of being compliant with accuchecks and diet but on top of body image issues...I'd be afraid almost where to begin! I'm sure these patients know the possible debilitating effects of DM, especially when it goes uncontrolled, but to chose the side effects of weight loss over the stress their bodies are put through it'd be hard to know how to help these patients.
  6. by   classicdame
    Yep, it happens. Teenage girls want to lose weight so they skip or reduce the dose of insulin. Teenage boys want to fit in, so they drink beer. Both end up with DKA. I have worked with diabetic peds for years and have seen this phenomena occur. Last year the number of children (under 18) diagnosed with Type II diabetes outnumbered the newly diagnosed Type I's. This means Hyperglycemic Hyperosmolar states will be seen in teens as well. Teens just think they are indestructable.
  7. by   daisey_may
    It's interesting you bring up drinking beer and diabetes. It doesn't have much to do with bulimia in that teenagers drink beer deliberately to lose weight, but it certainly is a side effect. Before I was in nursing school, I was under the impression diabetes only affected older people (the commercial---"If you have diabetes, and you are on medicare, your testing supplies may be covered..." comes to mind and is probably what gave me this impression) so the teenage, young adult and even older--are populations that may not receive as much education about what diabetes can do to them in the long run. And if , and when, they do receive education, the indestructible mindset may take precedence over what may happen to them down the road. It's sad, especially since the number of children diagnosed with Type II outnumber newly diagnosed Type I's. I don't work in pediatrics, but there are quite a few younger diabetics that end up the med/surg floor I work...and this certainly opens my eyes...
    Last edit by daisey_may on Oct 3, '07 : Reason: clarification
  8. by   classicdame
    Daisy May is right: beer drinking is less about bulimia than in self-image. However, Type I's who drink will not eat appropriately and may not medicate appropriately. They lose weight because their body is using fat for fuel - and end up in DKA. Type II's will use up available insulin when drinking because of carbs in beer. The liver gets busy clearing out alcohol so does not dump glycogen. The patient ends up in HYPOglycemia. Drinking in moderation can be part of a planned diabetic lifestyle for responsible adults but a lot of people, including teens, just don't understand the moderation concept. Also, Halloween is coming up. We will see plenty of admits of pedi diabetics.

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