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From Ohio, USA:

I have had type I diabetes for 17 years; I am going to be 21 soon. My question, or I guess, concern is diabetics who decrease their insulin so they do not have to eat. I am looking for a support group specifically for this problem. I am at my lowest weight ever. This has been going on for about three years now. I have sought professional help from both my doctor, and a number of shrinks. But I need to know the long term effects maybe to scare me and to put my distorted way of thinking back to reality.


It is fairly common for adolescent girls and young women to reduce their insulin dose in order to lose weight by diminishing their appetite. From what you write it sounds as though you may have progressed to a definite eating disorder though perhaps not yet to the formal definition of being >15% below ideal weight or of being amenorrhoeic for more than three months or having a history of purging or binging. It is however an important step in the right direction that you are able to talk about this both to your doctor and to a psychiatrist. Taken to an extreme, malnutrition can lead to cardiac failure and to a variety of metabolic distortions as well as kidney and even central nervous system damage but it does not sound as though you are near that stage. In your case there also is the danger of diminishing control of your diabetes.

Treatment is a slow process and consists of convincing you that you will not get fat and then by slow stages restoring body weight to the point that menstruation recommences. You almost certainly need the help of an experienced nutritionist in planning your recovery.

Support groups do not usually work with anorexia nervosa and bulimia; but in your case I am struck by your willingness to discuss your problem with a physician and a psychiatrist and to express it in e-mail. You should review this with your physicians because it may be that your underlying emotional problem is one that would be helped in a group and that one of them could suggest one.


Original posting 16 Mar 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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