THE RISKS OF MISMANAGED DIABETES

I've posted this article from the Daily Mail below as a warning to the risks diabetics take if they don't take care to manage their diabetes. It's often a problem with diabetics in their teens who feel isolated and want to be part of the crowd and be able to eat when they like, they just want to be the same as any other teenager. However diabetics aren't like normal teens as much as they would like to be and they think, "It won't happen to me that happens to other diabetics!" Diabetes is a serious condition so hopefully this article will raise awareness to the risks of not taking care.

Diabetic, 30, who skipped insulin jabs to lose weight fears she has been left infertile after having to terminate her pregnancy or risk death

• Jeorgia Wood, from Hampshire, was diagnosed with type 1 diabetes aged 11 
  
• Needed several insulin injections a day to control her blood sugar levels
• But they caused her to gain 4stone in weight and she began skipping them
• Is now suffering a series of health problems as a result - including infertility
• Also faces going blind, losing a limb and undergoing a pancreas transplant
• Said she wishes she could turn back the clock as being thin 'wasn't worth it'

A diet-obsessed diabetic who stopped taking her insulin to lose weight has suffered tragic consequences after having to terminate her pregnancy - or risk death.

Jeorgia Wood, 30, spent her teenage years and twenties dieting while battling diabetes because of her obsession to be thin. 

Like a growing number of young women with diabetes, she skipped vital insulin injections because they caused her to gain weight - a condition called diabulemia. 

But she is now suffering a number of serious health problems as a result.  As well as potentially destroying her chances of being a mother, she now faces going blind, losing a limb and undergoing a pancreas transplant.

Diabetic Jeorgia Wood, 30, withheld her insulin injections for years to avoid weight gain. She is now battling several serious health problems as a result

Dangerous: As well as potentially destroying her chances of being a mother, she now faces going blind, losing a limb and undergoing a pancreas transplant. Pictured here having laser surgery to try and preserve her sight

Jeorgia, a reiki practitioner from Odiham, Hampshire, said: 'I would much rather be fat and have a baby than be skinny, blind and childless. If I could go back to being 16, I'd tell myself that being thin isn't important.

'I've realised the hard way that being thin is just not worth it.'

Jeorgia and her fiance Ross Fowler, 28, were told the devastating news that she would have to terminate her pregnancy at 10 weeks last November.

 

Her battered body had reacted so negatively to being pregnant, she developed a condition called hyperemesis gravidarum, or unrelenting morning sickness. 

Causing her to be sick every 10 to 30 minutes, doctors said she wouldn't survive the pregnancy, nor would her baby. They added that her diabulimia was to blame. 

The condition describes the process of insulin-dependent diabetics skipping injections to make themselves thinner. 

It is usually linked to type 1 diabetes, where the immune system attacks the insulin-producing cells in the pancreas, rather than type 2 diabetes, which is associated with obesity and a sedentary lifestyle.

Insulin is a hormone that promotes fat storage, so avoiding taking it, or manipulating doses, can lead to weight loss.

Jeorgia, pictured on her 12th birthday, shortly after being diagnosed with type 1 diabetes.  As she began using insulin, she gained four stone in weight and began to worry about her diet 

Worried: By the time she was 17, she was a size 18 and 5ft 6in. She started skipping insulin injections to lose weight

The condition means Jeorgia may never be able to have a baby, but the couple have not completely ruled it out.

She said: 'It was incredibly distressing for us both. It's a risk and my doctors don't know for sure if I can carry a baby.'

Jeorgia, who was always a plump child, was diagnosed with type 1 diabetes, also known as juvenile onset diabetes, when she was 11 after she started losing weight, developed a raging thirst and suffered constant fatigue.

She was told she would have to monitor everything she ate and regularly check her blood sugar levels and needed to inject insulin four to five times a day to mop up excess sugar from her bloodstream. 

WHAT IS DIABULEMIA? 

Diabulemia is not yet officially recognised as a medical condition but it is predicted that it affects as many as one third of young female diabetics. 

It occurs when insulin-dependent type 1 diabetics skip insulin injections as a way of losing weight.

Insulin is a hormone that promotes fat storage, so avoiding taking it, or manipulating doses, can lead to weight loss.

It can cause blood sugar levels to surge causing fatigue, dehydration and the wearing of muscle tissue.

In the longer term, the symptoms are the same as for poorly managed diabetes and include kidney disease and sight problems.

Her diet was controlled as a child by her parents Charlotte, 63, and Peter, 68.

But when her weight ballooned and she gained four stone on insulin, she started to skip her injections and began to obsess over every morsel of food. She also wouldn't eat in front of anyone.

She said: 'From the age of about 13, I felt very unattractive. I hated the way I looked. I hated being different. If I dropped out of PE my classmates would say I was using it as an excuse, but I'd have done anything to be normal.

'By the time I was 17, I was a size 18 and 5ft 6in. If someone walked past me while I was eating a sandwich I would throw it in the nearest bin and pretend I was done with it. I thought people would judge me for my size.

'I started skipping my injections, losing weight very quickly, sometimes half a stone in a few days.'

Jeorgia shrunk to a size 10-12 and started to enjoy her new slimmer frame and relished on the compliments people would give her.

But cutting her insulin injections down to one a day left her constantly teetering on the brink of collapse. 

She had to drink copious amounts of water to combat her unquenchable thirst while trying to hide her problems from her family and friends.

Then, when she was 18, she collapsed on a night out with friends and was rushed to hospital, where she was diagnosed with ketoacidosis, a condition where the body's insulin levels are too low to convert blood glucose into energy. Left untreated, it can cause a coma and even death.

Stark implications: Even aged 25 (left), Jeorgia was still restricting her insulin injections. The damage she has caused herself meant she had to have part of her foot amputated last year (right)

 

But even then, she did not stop obsessing and instead was even more careful to hide her diabulimia from doctors.

'No one noticed what I was doing for ages,' she said. 'I was missing three or four injections a day and just doing one before bed to tide me over.

'I felt like I had flu every day of the week. But the more compliments I got the more paranoid I became about putting the weight back on.'

By the time she was 20, having noticed her monthly blood sugar tests were extremely high, Jeorgia's doctor warned her she would be blind and in a wheelchair by the time she was 30. But she still didn't start using insulin properly.

'I know it sounds crazy, but being thin mattered more. I told myself I'd only do it for a few more months but I just carried on and on and on,' she continued.

The turning point eventually came when she was 27 when, suffering from a stabbing pain in her hands and feet, she finally decided to seek help.

Warning: Jeorgia, who now weighs 13st and is a size 14, hopes her poor health will be a warning to other diabetics

'I went into rehab and it was there that it hit home how much I was hurting my family,' said Jeorgia. 'I was so wrapped up in my diabulimia that I'd failed to see anything outside myself. I knew I needed help.'

But the damage had been done and Jeorgia needed morphine to manage the pain and has since had to have an operation to remove dead flesh from her heel after catching an infection.

She's also been diagnosed with gastroparesis, paralysis of the stomach, and has had to have two vitrectomies to remove fluid from the inside of her eyeballs. Jeorgia also underwent a round of laser treatment to try to preserve her sight.

Furthermore, she has had to endure injections in her eyes for macular edema caused by protein which has been deposited on the eye and doctors are still not sure they will be able to save what is left of her sight.

The dangerous dieting has left her with permanent problems and Jeorgia now doesn't drive and needs Ross for even the simplest of tasks. 

A condition called autonomic neuropathy causes her heart to race at random and affects her blood pressure.

Now, aged 29 and weighing 13st and a size 14, Jeorgia is finally working to put her life right.

Together with Ross, a businessman, she has decided to delay a pancreas transplant to give her more time to try and start a family and find out what her options would be for an IVF surrogate to help them.

The transplant won't cure Jeorgia's diabetes, but will give her body a rest from the condition for eight to 10 years.

She added: 'After the transplant, my body will have been through a massive trauma and the chances of carrying a baby would be incredibly slim, as well as dangerous. So we want to see what our options are before we go down that road.

'I want to have a baby. I only hope I can hang on to the eyesight I have left in order to do that.

'There have been times where I've tried to push Ross away because I don't think I deserve his love.

'But he's asked me to marry him and all we can do is hope that one day we will have a child of our own.

Looking back, Jeorgia said that her need to feel loved and accepted was a major driving force behind her diabulimia.

'I felt worthless because I was overweight but I wasn't enormous, I should have seen that. Even when I tried to stop, the temptation to do it to lose a few pounds for the weekend was too strong.'

She hopes her experience is a warning to other young diabetes sufferers not to go down the same path she did.

Although not yet an officially recognised medical condition in the UK, diabulimia is a serious emerging problem that experts predict around a third of young female diabetics could be suffering from.

Deepa Khatri, a clinical advisor at Diabetes UK, said: 'People need to know that abusing insulin out of a fear of weight gain is very dangerous.

'Skipping insulin can lead to high blood glucose levels and devastating health complications like blindness, amputations and in some cases strokes.'

THE RISE OF TYPE 2 DIABETES MELLITIS

THE RISE OF TYPE 2 DIABETES MELLITIS

Diabetes occurs when either the pancreas fails to produce insulin, not enough insulin for the body mass or as an auto immune disorder. There are two types of Diabetes: is a disease brought on by either the body's inability to make insulin ( type 1 diabetes) or by the body not responding to the effects of insulin ( type 2 diabetes). It can also be brought on by pregnancy. Insulin is one of the main hormones that regulates blood sugar levels and allows the body to use sugar (called glucose) for energy.

Insulin is necessary to enable carbohydrates in the form of glucose, to pass through the body's cells membrane into the cell, the body's cells need energy in order to function and this applies to every cell in the body. It might be simpler to think of insulin as a door key, it unlocks the door to allow glucose to pass through. Now if there is no insulin, there is no key, so what does the body do, its cells still need energy to function, so it has to find an energy source via a different route. It does this by breaking down protein and it takes this protein from the body's muscles and organs, this is what happens in type 1 diabetes, where you see the characterises of severe weight loss and muscle atrophy. As the body does this it forms Ketones (a by product of breaking down protein for energy) and this gives rise to the characteristic acetone breath found in untreated type 1 Diabetics. Ketones in excess are harmful to the body.

With Type 2 this tends not to happen but the body's cells don't function so well and are essentially tired, so the diabetic will present symptoms of tiredness and lethargy. In some cases Diabetics with type 2 can go on to need insulin injections to manage their disease.

Type 1 Diabetes is often known insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes as it often begins in children and young adults and can start suddenly as a result after a viral illness such as the flu.

Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.

Lastly  we have Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2

There are other forms much rarer such as congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes. But since I wish to focus of the rise of type 2 and the problems this causes I won't discuss this here.

The rise of type 2 diabetes is because of an increase of obesity, not just in adults but this is now being found in overweight children. More and more of the population are eating a poor diet with too much refined sugars and carbohydrates and not enough exercise. Children in particular seem to be spending more time in front of game consuls and TV and computers instead of running around in the fresh air. It's also an easy option to keep them quiet by feeding them bags of artificially flavoured crisps, sweets and sugar laden fizzy drinks, instead of spending time with them or encouraging healthy snacks such as fruit and encouraging them to drink water when they are thirsty. The same goes for adults, in particular when it comes to taking children to school, instead of walking with them, its too easy to drive them, that does not help with carbon foot prints but thats for another blog in due time lol. In yesterday's blog I discussed how eating too much refined carbohydrates created sugar highs and lows facilitating cravings and leading to eating more of these products. Type 2 Diabetes is often initially managed by increasing exercise and dietary modification. If the condition progresses, medications may be needed.

So what does being Diabetic mean for the patient? It means changes in life style especially so for Type 1 diabetics, where blood sugar levels have to be constantly managed and insulin needs to be replaced by regular injections. Food intake, particularly carbohydrates and exercise have to be carefully managed so prevent coma and if untreated can lead to death, its that serious. Management is gravely important as serious health conditions can be the result, such as the loss of limbs, heart attacks and blindness.

Studies in the United Kingdom have shown that the prevalence of impaired glucose tolerance in the 35-65 year age group is about 17%. This is known as pre-diabetes or impaired glucose tolerance. While people with pre-diabetes usually have no symptoms, it’s almost always present before a person develops type 2 diabetes. However, complications normally associated with diabetes, such as heart disease, can begin to develop even when a person has only pre-diabetes.

Once type 2 diabetes develops, symptoms include unusual thirst, a frequent need to urinate, blurred vision, or extreme fatigue. Talk to your doctor to see if you need to be tested for pre-diabetes. By identifying the signs of pre-diabetes before diabetes occurs, you can prevent type 2 diabetes all together and lower your risk of complications associated with this condition such as heart disease.

In type 1 Diabetes the onset is rapid, weight loss, tiredness and complete exhaustion and since the body cannot use or get glucose into the body's cells, it remains in the blood, whereby the kidneys then filter it out of the body into urine, The untreated diabetic's urine has a characteristic sweet aroma. It's full name is Diabetes Mellitis and comes from the latin meaning copious amounts of urine smelling like honey. As the concentration of sugar is very high the body needs to dilute the sugar in the blood. The hypothalamus that area of the brain that is responsible for maintaining homeostasis sends a message to the area of our brains responsible for making us feel thirsty, so in both types of diabetics there will be an increased thirst. Therefore the diabetic will be both thirsty and passing a great deal of urine. Type 2 diabetes is more insidious it creeps up more slowly so the patient might not be aware of an increased thirst or passing more urine but may have noticed they are feeling more tired than usual, or they may notice the development of thrush, as thrush thrives in sugar laden tissues, or skin infections such as boils.

GANGRENE CAN OCCUR THROUGH POORLY MANAGED DIABETES

Coming back to the body's cells because all of the body's cells will be tired this includes blood cells, white blood cells and T'lymphocytes responsible for fighting infection wont work so well and wont be able to cope with infection as well as the non diabetic, hence the increase in skin infections, such as boils, poor healing etc. Nerve cells will also be tired, this goes from the brain all the way to the peripheral nerves, so we have mental exhaustion and nerves responsible for picking up sensation will be impaired so if an infection occurred say in the toes, where a non diabetic might feel the pain of an infection occurring, the diabetic will not, coupled with poor healing you can see why diabetics must be careful with something we take for granted like cutting toe nails as the risk of infection is much greater. The same goes for women diabetics, they shouldn't have waxing as the risk of them developing a serious infection is much greater. The blood vessels are comprised of cells of course, so these will also be compromised, therefore the diabetic's circulation, especially to the extremities, like the toes can become impaired, so the diabetic because their nerve sensations are impaired will not be aware of the circulation is not as efficient. All the body's cells require oxygen, which is delivered by the blood, without this cells will die, the cells will not be able to receive any nutrients either, so they cannot thrive if this happens we have tissues dying which is known as gangrene. If this is not treated, it can become infected and spread, which could result in death and certainly the necessity of having the dead tissue removed  resulting in amputation. Blindness is another complication since the body's cells, the blood vessels to the eyes are impaired. Infection in general, not just in the soft tissues but any infection can become serious for the diabetic as they are not as efficient wilt dealing with infection as the non diabetic. There is an increase in heart disease  too in diabetics, the heart is also as we know comprised of different types of cells, so you can be sure they are not working as efficiently as the non diabetic. These risks can be lessened with good management of the condition, so it is essential the diabetic takes care of their health and they do this by monitoring their blood sugar levels so that they are kept within normal levels. With type 1 this means constantly checking their blood several times a day, in a type 2 diabetic it means taking your medication you are prescribed and following the diet given to you and with all diabetics you must be vigilant in looking out for infection and any changes or worries discuss them with your doctor and don't put this off.

Prevention is always better than cure and there is much we can do to prevent type 2 Diabetes, there is no excuse to having this in children who are obese and its tantamount to child neglect allowing children to become so obese in the first place. If we all looked after our health, by eating a healthy balanced diet and taking regular exercise and maintaining a healthy weight, not only would we be helping ourselves to better health but we would be saving the country a huge expense.

Maggie Brown (Author)

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