Diabetes is a disease that affects an estimated one million people or more in the United states alone. It’s a disease that’s characterized by the body’s inability to make, process or use insulin sufficiently. Diabetes can affect just about anyone but there are risk factors that make some more susceptible than others. By far obesity is the biggest risk factor, followed by a family history of the disease. Blood glucose or sugar is what the body uses for energy, insulin the hormone that helps to convert the glucose into energy for use in other parts of the body is created in the pancreas, it uses the food that is consumed to create insulin. When the pancreas is unable to convert the glucose for use by the body, it stays in the blood stream and builds up causing other health issues.
There are two main types of diabetes, Type I and Type II and both are different in the way that they affect the body, the times at which they present and the ways in which they’re treated. In Type I diabetes the body cannot create insulin because the immune system of the body will attack the cells in the pancreas that are responsible for that task. This is the form of diabetes that is most commonly found in children and young adults and is not a developed disease but rather an innate one owing to defective beta cells at the start. Treatment for this type is the taking of daily insulin shots as well as strict dietary management and monitoring of blood glucose levels.
With diabetes comes a lot of risk factors for developing other disease and disorders. Because the main cause of Type II diabetes is obesity maintaining a healthy balanced diet and proper exercise is key to lowering the risk factor. Those with diabetes are at risk for stroke, heart disease, kidney disease and developing, eye, dental, nerve and foot problems. One of the many secondary disorders that can affect diabetics is an eating disorder particularly in women and adolescent girls. Whether because of the stress involved with managing the disease or other outside factors is not entirely clear, but most psychologists agree that the main motivations of an eating disorders stems from stress and a lack of control in one's life coupled with the desire to exert some control over some aspect of the life.
What are Eating Disorders?
For teenagers however, the stress of Type I diabetes as well as the pressure to conform, particularly in teenage girls to fit a physical aesthetic can be daunting and result in disorganised eating. Eating disorders are characterized by disturbed eating patterns that are persistent and impair the medical and psychological health of the subject. They are divided into eight categories based on the symptoms and observed behaviors. By far the common are Anorexia Nervosa and Bulimia Nervosa.
In Anorexia Nervosa there are two forms in which subjects will participate, restrictive and a binge-purge dichotomy. Restrictive anorexia is characterized by the subject consuming extremely small amounts of food, for instance four crackers for lunch and nothing else, this will often be combined with excessive exercising. In the binge-purge dichotomy, subjects will occasionally in response to feelings of guilt in relation to eating, consume overly large quantities of food in one sitting and shortly thereafter induce vomiting, take large quantities of laxative or indulge in even more rigorous exercise in an to get rid of all that they have eaten.
Bulimia Nervosa is characterized by both a binge-purge dichotomy and a non purging aspect. The binge-purge will look almost identical to that of anorexia, but the non-purging aspect instead of reliance on laxatives or vomiting to get rid of the food that was eaten, subjects will engage in over exercising or go on fasts. Eating disorders affect one in twenty teens, and it disproportionately affects girls more than boys at a rate of ten times more, older women are however not immune to developing eating disorders at any time.
Effects of Eating Disorders in Diabetics
It probably isn’t that surprising that with the societal pressures to look a certain way or be certain size that many teenage diabetics would succumb to those pressures and use their disease in a way that they perceive to be a benefit to them. Many intentionally take too low a dosage of insulin so as to harness the side effects of a lack of insulin which stops food from being processed in in turn will keep their weight down. What they don’t know about most often are the long term side effects such as blindness as renal failure.
One side effect is diabetic ketoacidosis which is a serious complication that occurs when the blood glucose levels are extremely elevate and symptoms can develop rather quickly sometimes within a twenty-four hour span. It can be potentially deadly in it’s own right as it causes fatigue, extreme thirst, confusion, increased urination, abdominal pain, shortness of breath and nausea or vomiting, left untreated it can lead to unconsciousness and death.
While the symptoms of ketoacidosis can be frightening as well as life-threatening, the treatment can be equally as frightening with possibility of complications and even death. Treated with a combination of electrolytes such as potassium, sodium, chloride and insulin complications from treatment can include low blood sugar is the insulin causes the blood sugar to drop too quickly. Low potassium that can affect the heart, nerves and muscles. Cerebral edema that causes brain swelling due to rapid adjustment of sugar levels and is more common in children.
The high glucose levels in the blood will start to damage nerves over time. When that happens two of the side effects are peripheral diabetic neuropathy a condition that causes pain, loss of sensation and burning in the feet usually beginning in the toes but can migrate to other parts of the body. If left untreated amputation may be the final result. Autonomic neuropathy involves damage to nerves in the organs of the body and can lead to sexual dysfunction, gastroparesis, not being able to tell when the bladder is full which can lead to accidents, not knowing when the blood sugar if low leading to more severe accidents such as fainting.
Diabetic neuropathy although a less common occurrence, is a serious complication. When there is an elevated levels of glucose in the body, the body will try to expel the excess by processing it through the kidneys as urine. Additionally patients will also feel thirst more often which will then prompt them to take in more liquids, which will then again create more urine for expulsion. This can damage the functions of the kidneys and cause them to lose the ability to properly process the waste products from the blood, left untreated this can lead to renal failure and necessitate the need for dialysis.
Helping Diabetic Teens With Eating Disorders
Because teens with eating disorders are mostly self-reported it can be challenging to find ways of helping them cope not only with the stress of their disease, but with the pressures of fitting in with their peer groups. If an eating disorder is suspected one of the first things to do is get the patient to a physician to determine what if any damage has been done to the body. Once a determination has been made, the physician can work with the patient and parents to come up with a healthy eating plan and discuss the benefits of therapy to address the underlying issues of the eating disorder. Coming back from an eating disorder can be tricky and hard, and psychologists admit that once someone has had an eating disorder they are always at risk for another. But with proper help, support and guidance it does is not an insurmountable task.