On August 4, 2017, Ms Megan Davidson, 27, commited suicide after battling with diabetes and diabulimia.

Megan was driven to suicide after her battle with her eating disorder and diabetes.

She died three days after she was discharged from mental health services after they thought she did not to have clinical depression and had full capacity according to the inquest.

On the morning of her death she had texted therapist, Renata Harris, saying: ‘Please make sure the emergency services find my body so my parents don’t have to.’

The 27-year-old’s body was found by police who had eventually been alerted by the therapist who received Ms Davison’s text message.

Ms Davison had previously tried to kill herself at the end of 2016 through an overdose.

The therapist decided the text had no ‘immediate implications’ and so did not tell anyone about it for almost an hour.

When police were contacted they went to Ms Davison’s home in Cheshunt, Hertfordshire, and found her body.

 

Megan is not alone,

The word diabulimia is a merger of the word diabetes and bulimia.

Though this word is not officially recognized, Diabulimia describes the situation where somebody deliberately and regularly reduces the amount of insulin they take due to concerns over their body weight and/or shape.

The American Diabetes Association indicates that 30-40 percent of female teenagers and young female adults with diabetes alter or skip insulin to control their weight. “If you have diabetes, then the risk of developing an eating disorder is about twice as likely than if you didn’t,” says Ronald Steingard, M.D., of Walden Behavioral Care in Waltham, MA and research consultant for Harris Center for Eating Disorders at Harvard University.

 

Individuals suffering from diabulimia intentionally misuse insulin for weight control, including:

• Decreasing the prescribed dose of insulin
• Omitting insulin entirely
• Delaying the appropriate dose
• Or, manipulating the insulin itself to render it inactive

 

On the long term, there is severe hypoglycemia and weight loss because the body would break down fats for energy since there is no insulin to help the tissues utilize glucose effectively.

Diabulimia is a mental health issue and health care providers should be able to recognize this and refer appropriately for psychological help if need be.

Although, this might not be popular among Nigerians, it just might  be because we do not have enough statistics and so many people with mental health issues do not regularly reach out for help.

Warning signs and symptoms of diabulimia

Emotional and behavioural

 

• Secrecy about diabetes management
• Increased neglect about diabetes management
• Avoiding diabetes related appointments
• Fear of low blood sugars
• Fear that “insulin makes me fat”
• Extreme increase or decrease in diet
• Extreme anxiety about body image
• Restricting certain food or food groups to lower insulin dosages
• Avoids eating with family or in public
• Discomfort testing/injecting in front of others
• Overly strict food rules
• Preoccupation with food, weight and/or calories
• Excessive and/or rigid exercise
• Increase in sleep pattern
• Withdrawal from friends and/or family activities
• Depression and/or anxiety
• Infrequently filled prescriptions

 

Physical 

• A1c of 9.0 or higher on a continuous basis
• A1c inconsistent with meter readings
• Unexplained weight loss
• Constant bouts of nausea and/or vomiting
• Persistent thirst and frequent urination
• Multiple DKA or near DKA episodes
• Low sodium and/or potassium
• Frequent bladder and/or yeast infections
• Irregular or lack of menstruation
• Deteriorating or blurry vision
• Fatigue or lethargy
• Dry hair and skin

It would be of immense help if

• Psychological factors should always be considered, assessed and excluded in all episodes of DKA.
• Sufficient time, resources and training must be in place to enable diabetes healthcare professionals to identify and support people with diabulimia effectively.
• 

References

1) Colton, P. A., Olmsted, M. P., Daneman, D., Farquhar, J. C., Wong, H., Muskat, S., & Rodin, G. M. (2015). Eating disorders in girls and women with type 1 diabetes: a longitudinal study of prevalence, onset, remission, and recurrence. Diabetes care, 38(7), 1212-1217.

2) Svensson, M., Engström, I., & Åman, J. (2003). Higher drive for thinness in adolescent males with insulin‐dependent diabetes mellitus compared with healthy controls. Acta Paediatrica, 92(1), 114-117.

3. http://www.dailymail.co.uk/news/article-5554981/Patient-27-killed-asked-therapist-note-send-Dignitas.html
4. Nationaleatingdisorders.org

 

 

Diabetes is a condition that sadly has no cure but what is even more saddening is that there are people out there who are exploiting innocent people just in the bid to get them cure.

This was the case of Adeniyi Adewunmi, a self-acclaimed herbalist who allegedly swindled a businessman of 190 million claiming he’ll cure his diabetes.

The case was brought before an Igbosere Magistrates’ Court in Lagos where the accused, aged 43, is standing trial on a four count charge on conspiracy, fraud and stealing.

The Prosecutor, Friday Mameh said before court that the offences were commited between Feburary 2016 and January 2018.

“The accused and others still at large approached the complainant, one Mr Lawrence Akanbi, and told him that he is suffering from diabetes, asthma and spiritual attack”.

“The complainant believed because he was actually suffering from the ailments stated by the accused”.

“The accused used the opportunity to ask the complainant for money till the money amounted to N190m,” Mameh said.

The complainant, hoping for a cure, noticed his symptoms were rather getting worse and the accused arrested by the police.

The accused however denied the allegations.

The Magistrate, Mrs F.O. Botoku, granted him bail in the sum of N20m, with two sureties who must not be less than grade 16 in the civil service  in like sum.

The case was then adjourned the case until Feb. 12 for trial.

 

 

 

Source : The Punch Newspapers

Before the discovery of insulin, the chances of having a baby with diabetes was really slim, but thanks to Banting and Best, the discovers of insulin, this century has seen better outcomes for mothers living with diabetes and their children. In Nigeria 1.7 percent of pregnant women have diabetes out of which 61 percent is gestational diabetes.

Pregnancy in itself is a diabetogenic state i.e pregnancy raises blood sugar levels in normal conditions . Diabetes may complicate pregnancy because a woman had diabetes before pregnancy  (pregestational diabetes which can be type 1 or type 2)or she developed diabetes during the course of her pregnancy (gestational diabetes). Gestational diabetes usually resolves few weeks after the baby is born. However, in about 60-70 percent of women, there is a recurrence in subsequent pregnancy.

 

The challenge

The body is more resistant to insulin during pregnancy to allow more glucose available to sustain the growth of the baby. This makes the body require more insulin production. In people with gestational diabetes, the pancreas can’t keep up with the production of insulin required and so the blood has excess glucose.

The main effects of diabetes in pregnancy is that it increases the risk of miscarriages in early pregnancy it increased risk of babies with congenital malformations e.g with cardiac problems . This is in people with poorly controlled diabetes. It is not uncommon to see people with diabetes developing hypertension and infections in pregnancy.

Too much glucose gets into the baby’s blood and causes accelerated growth of organs especially in the middle and late stages of pregnancy.  This results in big babies, too big to enter the birth canal and can cause the baby’s shoulder to be stuck (shoulder dystocia) making caesarean section necessary in some cases.

Shortly after birth, your baby may have low blood sugar (hypoglycemia) because his body will still be producing extra insulin in response to your excess glucose.

The baby is at risk of hypoglycemia immediately after birth because the baby was used to having excessive insulin action while in the womb. It is recommended that the mothers breast feed their babies shortly after birth to help reduce this.

There is also a a higher risk of having breathing problems because the lungs do not mature well enough and the baby might have neonatal jaundice.

Who should be more concerned?

Women above 35 years

People whose immediate relatives have diabetes

People who have had big babies (4.5kg and above) in the past.

People who weigh beyond 90kg or have a BMI above 30.

People who have had stillbirths without a known cause.

People who have had babies with birth defects

People with polycystic ovarian syndrome.

 

What to do?

Mums-to-be  need to check their sugar levels early in pregnancy during their first trimester.

A woman with diabetes or impaired blood sugar levels should consult with a doctor- both an obstetrician and a physician- even before the start of pregnancy. A dietician also plays a role of helping to maintain a healthy diet.

A diet of someone with gestational diabetes should be between 1500-2000 calories and there should be good combination of carbohydrates with protein and fats.  An HbA1c of between 4-6 is the usual target.

It is also important to take folic acid (5mg) before aiming at pregnancy for people at risk.

People living with diabetes before pregnancy would need to really monitor their sugar levels closely has pregnancy can alter their feeding patterns and they might require higher levels of insulin.

A woman who has had diabetes in previous pregnancy is advised to have yearly medical checks as she’s at risk of developing type 2 diabetes in the future.

The pre-pregnancy states are very important. A woman with good glycemic control before pregnancy is more likely to have a better outcome.

 

Today is World Mental Health Day.

According to the WHO, Health is a state of complete physical, social and mental wellbeing and not merely the absence of disease or infirmity.

1 in 5 Nigerians have mental health issues.

So many people go through mental health issues unrecognized.

Nigeria is in dire need of mental health awareness as well as diabetes awareness as there are a lot of societal stigma attached to these conditions.

So many people would rather go to a spiritual home without consulting a physician for their mental health conditions.
It is not only those on the streets with tattered clothing that have mental health issues. So many people around us in our families or workplace might also be victims.

Mental health problems also coexist in about 25 percent of people with health challenges one of which is diabetes mellitus.

Why are people living with diabetes at risk of developing mental health problems?
Having depression raises your risk for onset of diabetes, just as having diabetes raises your risk for onset of depression. Depression can lead to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain — all of which are risk factors for diabetes.

Getting a diagnosis of diabetes in itself can lead to some emotional responses like anger, denial and fear which is normal in the initial stage of grief. However, this can be prolonged and then can lead to a myriad of problems.
Newly diagnosed people living witb diabetes can exhibit anger and wonder why they are diagnosed when other friends and relatives do not have the condition.

The stress involved in the entire lifestyle change of being careful with choice of food, regular blood sugar checks and having to take insulin can take a toll on a person.

Anxiety disorders, substance use disorders, eating disorders and post traumatic stress disorder are also common among people living with diabetes.

The financial and social burden of living with diabetes can also predispose to mental illness.
People with mental health challenge increases their risk of diabetes complications as they are more likely to be non-adherent to medications and self care.

It has been said that mental health state can affect treatment outcome of diabetes. For instance, Women with type 1 diabetes and eating disorders have poorer glycemic control, with higher rates of hospitalizations and retinopathy, neuropathy, and premature death compared with similarly aged women with type 1 diabetes without eating disorders.
The American Diabetes Association recommends that clinicians routinely screen diabetes patients for psychological problems; however, few diabetes clinics do provide those mental-health screenings
The World Health Organization estimates that diabetes will affect more than 350 million persons worldwide by 2030, with the number of persons affected more than doubling from the year 2000.

HOW TO PREVENT MENTAL HEALTH PROBLEMS IN PEOPLE LIVING WITH DIABETES
People living with diabetes need care, love and support from friends and family.
Learn coping mechanisms – diabetes management should include self care mechanisms. Exercise is said to be helpful in reducing stress and depression due to release of endorphins.
Find a support network or group.
Eating balanced diet.
Adequate sleep.
See a doctor for regular mental state examination and psychotherapy.

You can still win an all expense paid trip to a diabetes youth camp in Ghana . Click here

There could be a lot of struggle for people living with diabetes especially when they’re going through it alone. There could be frustration for both the child and the care givers.
WHY SHOULD YOU ALLOW YOUR CHILD GO TO A DIABETES CAMP?
Camp experience is always exciting and it makes all the difference!

Diabetes camp provides fun and excitement while creating an avenue to learn more about how to manage diabetes. It allows children living with diabetes and those at risk of developing type 2 diabetes to learn in a safe and fun environment. It builds a community of people who grow together knowing they are not alone. It’s also a great opportunity for networking.

Camp is a lifeline for children with diabetes to develop the critical skills they need to manage the disease. Children get to be surrounded with people who understand their fears and frustrations; people who ‘get it’.
They learn about how to manage their diet, understand the symptoms and how their daily activities affect their health
It also helps build Confidence. It might be all you need to get your child motivated in a medically safe environment while also acquiring social skills and lifelong relationships (diabuddies!).
HOW TO WIN
Share a one minute video about your diabetes journey and stand a chance to go on an all expense paid trip to the West Africa Diabetes Youth Camp in Ghana from the 17th to 19th of November, 2017.

Send the video to our facebook page ‘NGDOC’.
Participants must be between ages 10-25 and must be able to attend the meeting.
Winners would be selected and reached.
For more information, Please send a mail to thengdoc@gmail.com