I’m a 23 year old female who has had type 1 diabetes for three years, and for the past year, I have had great troubles keeping my appetite under control. I’m now also seeing a psychiatrist and taking a Prozac analog used in treating eating disorders. Nevertheless, it doesn’t seem to help. I don’t vomit nor use any laxatives, I just eat huge quantities of food (including sweets), and then I don’t measure my blood glucose levels (although I know that they must be very high). I keep promising myself that this was my last binge, but there always comes the next time. I would like to get your advice as to what should I do to stop destroying myself like that.

As you already know, the combination of an eating disorder and type 1 diabetes can be very dangerous. Please call your psychiatrist immediately and let this clinician know about how much you have been struggling. Also, ask if there is someone you can be referred to with expertise in diabetes and eating disorders. If your psychiatrist does not know of anyone, please contact your diabetes team and see if there’s someone they refer to.

Another option is to ask your team if they could admit you to a hospital for a week or so, where they can control your food intake, and where the staff will be monitoring your blood sugars and giving you your insulin. Perhaps a week of having someone else take care of your diabetes and your food intake will be helpful in getting back on track.

Please get help immediately, and do not give up until someone listens to your concerns.

JWB