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October 19, 2004

Behavior, Weight and Weight Loss

Question from Hillsburgh, Ontario, Canada:

My daughter is 17 years old and has always been worried about her weight. I have given her control of her blood readings and insulin over the past six months. But, today, I have found out she has been skipping her blood readings and insulin to loose weight. I am so worried! Her reading tonight was 28.8 mmol/L [518 mg/dl] at dinner I have given her Humalog, which I hope brings it down. As for a Support Clinic, she has one but it is run very poorly and the support is just not there. I am so scared and unsure who to talk to. What should I do?

Answer:

Adolescent girls with type 1 diabetes do seem to be at higher risk for disordered eating than girls without diabetes. The research suggests that this is both because keeping tight control over blood sugars often leads to weight gain and, also, because missing insulin injections causes you to lose weight. Unfortunately, missing insulin can lead to life-threatening consequences, so it is an extremely dangerous method for weight loss. Your daughter may be at great risk.

It sounds like you feel as if your daughter’s diabetes team is not supportive of you as a family and not able to understand the extreme seriousness of her struggle with weight. Please look for a different diabetes program in your community or even further away if necessary. Also, please contact the Canadian Diabetes Association chapter near you to see if they recommend programs and to see if they recommend mental health professionals for your daughter to see. You can also talk to your own primary care physician, as well as your daughter’s primary care physician, to see who they recommend to help young women with eating disorders.

While you are seeking the professional help that your daughter needs, you may also consider taking over her diabetes regimen for a while. See if you can convince her to let you check her blood sugars and administer her insulin injections. Your supervision and oversight may be the thing that keeps her safe.

JWB