title: Intentional hypoglycemia to control bingeing in a patient with type 1 diabetes and bulimia nervosa.
abstract: Most cases of eating disorders associated with type 1 diabetes mellitus are categorized as diabulimia, a disorder of withholding insulin treatment to lose weight through sustained hyperglycemia. In this paper, we report a unique case of a patient with both type 1 diabetes and bulimia nervosa who has an atypical way of controlling her bingeing by keeping her blood sugars low. This pattern of intentionally sustained hypoglycemia has not been previously described in the literature to the best of our knowledge. Knowing various presentations of eating disorders in patients with type 1 diabetes can provide healthcare workers with enhanced ability in recognizing and educating at-risk patients, in the hope of preventing serious hypoglycemia or complications. Furthermore, a patient's awareness of complications associated with suboptimal control of diabetes, whether by overdosing or underdosing their insulin regimen, might lead to avoidance of disordered eating behaviours.
authors.affiliation: Vancouver Coastal Health, Vancouver, British Columbia, Canada. Electronic address: mandana.moosavi@mail.mcgill.ca.
authors.forename: Mandana
authors.initials: M
authors.lastname: Moosavi
authors.affiliation: Saint Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Stuart
authors.initials: S
authors.lastname: Kreisman
authors.affiliation: Saint Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Lacresha
authors.initials: L
authors.lastname: Hall
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000523:psychology; D062787:Drug Overdose / Q000523:psychology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007328:Insulin / Q000008:administration & dosage
chemical_list: D007328:Insulin
keywords: anorexia nervosa; anorexie mentale; diaboulimie; diabulimia; diabète de type 1; hypoglycémie intentionnellement provoquée; intentional hypoglycemia; type 1 diabetes