Diabulimia and Type 1 Diabetes: An Unknown and Emerging Problem

Title:Diabulimia and Type 1 Diabetes: An Unknown and Emerging Problem

Volume: 24

Author(s): Benedetta Rivolta*, Benedetta Masserini, Irene Bernardi, Antonella Camera, Federico Liboà, Sebastiano Bruno Solerte, Chiara Cerabolini and Nadia Cerutti

Affiliation:

• Dirigente Medico, SC Nutrizione Clinica, Diabetologia e Malattie Endocrine, ASST Pavia, Italy

Abstract: Background: T1DM patients have a higher prevalence of eating disorders than the general population, and up to 30-40% of young T1DM patients suffer from an eating disorder, including diabulimia. Eating disorders worsen glycemic control and make insulin therapy management more difficult. Closed loop systems (HCLS) allow major therapeutic flexibility; however, proper carbohydrate (CHO) counting remains a fundamental feature for insulin dose adjustments.

Case Report: A 30-year-old female patient affected by T1DM (with a past medical history of drug abuse and depressive syndrome) presented with inadequate glycemic control and prandial boli management. She started a CHO counting course and had a HCLS positioned, with progressive amelioration of glycemic control. During follow-up evaluations, HCLS data showed a progressive reduction and abeyance of prandial boli; the patient also developped an excessive fear of weight gain. An integrated approach between diabetologist, psychiatrist and dietitian allowed a diagnosis of diabulimia, an eating disorder characterized by a progressive reduction and elimination of carbohydrate ingestion and insulin boli, with episodes of uncontrolled binging and purging. A multidisciplinary approach (fortnightly dietetic and psychiatric evaluations, use of bioimpedance, fixed CHO content diet) allowed the patient to reach a better glycometabolic control and disease consciousness.

Conclusion: T1DM patients need to pay great attention to food quality and quantity; hence, an eating disorder diagnosis may be challenging. Additionally, there are currently no standard screening methods for this purpose. In our experience, an integrated approach is fundamental and may be a valid strategy to face this emerging problem.

Cite this article as:

Rivolta Benedetta*, Masserini Benedetta, Bernardi Irene, Camera Antonella, Liboà Federico, Solerte Sebastiano Bruno, Cerabolini Chiara and Cerutti Nadia, Diabulimia and Type 1 Diabetes: An Unknown and Emerging Problem, Endocrine, Metabolic & Immune Disorders - Drug Targets 2024; 24 () . https://dx.doi.org/10.2174/0118715303314948240419060714

DOI https://dx.doi.org/10.2174/0118715303314948240419060714	Print ISSN 1871-5303
Publisher Name Bentham Science Publisher	Online ISSN 2212-3873