Doing it for DWED, what’s it all about?

Forgive the wordy introduction, I hope this will explain the background to this blog, and the organisation I hope to support by running in the Bath Half Marathon on March 11^th 2012.

I’ve been lucky with my diabetes diagnosis, if one can be thought of as ‘lucky’ learning you have a lifelong disease that will require my attention each and every day for the rest of my life, with the lurking threat of frightening complications shadowing countless daily decisions. I’m lucky because it is something that came to me when I had already passed my childhood years, turbulent teen and University times, and on through my twenties, thirties – almost entirely through my forties. So it was something I didn’t have to deal with for nearly five decades when so many other things were happening. As I have come to understand more about diabetes, particularly Type 1 as that is my particular flavour, I have learned that there is an enormous number of ways that people can be affected, some of which I would never have dreamed of. One such carries the name of diabulimia. No doubt many people are aware that it is often the case in our image-conscious, peer-pressured society that young people can succumb to eating disorders in an attempt to achieve an appearance that matches some mythical ideal. We know these as anorexia and bulimia.

Diabulimia is bulimia with a twist, it uses the medical certainty that a body denied insulin will lose fat in order to provide energy. A hundred years ago, insulin was unknown, and people with Type 1 diabetes would rapidly waste away to shadows. I myself experienced a sharp confirmation of this in the days before I was diagnosed – I lost 17 pounds in three days. Imagine then if, in a weight-conscious society and for whatever psychological reason, you wished to control your weight and you had a tool at your disposal – insulin. People with Type 1 diabetes need insulin to live, either by injecting it or delivering it via an insulin pump. If you have no insulin circulating then your body has to get its energy by converting fat cells – and it needs energy whether you eat anything or not, as your heart, lungs, brain and digestive system all need energy all the time you are alive. Unfortunately, using fat as an energy source results in by-products called ketones being produced. In a non-diabetic person the ketones will be processed from the system naturally – this is called ketosis and is what happens when people diet to lose weight. However, in order to process those ketones you need…insulin. Without insulin the ketones build up in the blood, raising the acidity and affecting all major organs. Should the levels of ketones rise too high they will result in the potentially life-threatening condition known as DKA – diabetic ketoacidosis. DKA can quickly lead to coma and death if not treated urgently – this is what I was suffering when I was diagnosed and believe me, it is something I NEVER wish to experience again!

You can see, therefore, that withholding insulin will cause weight loss, not only through the consumption of fat for energy, but also in dehydration as blood sugar and ketone levels rise and the body tries to rid itself of the excesses through urine – or even the breath: the breath of a person in ketosis will often smell of acetone, or pear drops and breathing may become rapid and laboured as the body struggles. To even approach this state is taking a huge risk. Not only fat will be consumed in the search for energy, but also protein, including muscle tissue - and that includes the heart. Yet it is thought that as many as 40% of 15 to 30 year olds regularly omit insulin.

Despite the horrendous complications and staggering prevalence, diabulimia or ED-DMT1 (Eating Disorder in Diabetes Mellitus Type 1) is not diagnosable and there are no current guidelines for the NHS on how to deal with the issue. Thankfully, there is an organisation that can help: DWED, or Diabetics With Eating Disorders. Please visit their site to read about what they can offer. They are only a small charity, but I think it is essential that they can continue their work to help people who may have access to no other support and understanding of the particular problems and dangers involved. Please visit my justgiving page and sponsor me for whatever you can - I can assure you every penny will be appreciated and will directly help transform lives for the better.

I'll be updating this blog with reports of my progress and hopefully lots of other stuff!