Amid the all-too-familiar collection of side effects associated with diabetes—poor circulation, eye, nerve, heart, kidney and even gum problems—is a condition few know about.

It’s called diabulimia, and it is an alarming phenomenon that has only recently garnered attention from mainstream media despite having been documented in research literature since the late 1980s.

A blend of the words diabetes and bulimia (the eating disorder marked by consuming foods then purging them by self-induced vomiting), diabulimia is an extreme weight loss method practiced by individuals with type 1 diabetes, who deliberately reduce or completely skip required daily insulin shots in order to induce rapid weight loss.

In type 1 diabetes, the body does not produce insulin, the hormone required to convert sugar, starches and other nutrients into energy needed for daily life. This is why those with type 1 diabetes must regularly take insulin. When insulin is restricted, sugar is excreted in the urine rather than being used for energy or stored as fat. Blood sugar levels can surge and reach an unsafe level, leading to fatigue, dehydration and the breakdown of muscle and fat. A state of starvation and weight loss follow.

The practice has gained attention from experts due to the significant medical complications and risks associated with it.

In response to increased prevalence and the need for insight about the condition, the American Association of Clinical Endocrinologists (AACE), along with the American College of Endocrinologists (ACE), AACE`s educational and scientific arm, are promoting awareness and education about the condition. They have created an informational video, which is posted online here.

The video provides clinical information Kathryn E. Ackerman, MD, an endocrinology and sports medicine specialist, as well as observations about the condition provided by several  patients with diabetes, including Maryjeanne Hunt, a survivor of diabulimia and published author of “Eating to Lose: Healing from a Life with Bulimia,” which chronicles her journey from illness to recovery.

And although diabulimia is not classified as an official type of eating disorder—the name itself is a relatively recent creation—the behavior is believed to be widespread, with published reports suggesting that as many as one-third of all females with type 1 diabetes, or a staggering 450,000 women in the U.S., have engaged in the potentially lethal practice for weight control.

“The consequences of manipulating insulin in this manner not only can significantly accelerate the long-term medical complications of diabetes, but also place the sufferer at risk for a life-threatening condition known as diabetic ketoacidosis,” says Jeffrey R. Garber, MD, chief of endocrinology at Harvard Vanguard Medical Associates and President of the American College of Endocrinology (ACE). “Diabulimia clearly is a major problem that is underappreciated and calls for greater awareness.”

Additional information about diabulimia is available on ACE’s patient education website.

"It is our aim to increase awareness about eating disorders in patients with diabetes and the enormous risks associated with restricting insulin” says Dr. Garber.  “We’re hopeful that our video, along with additional information on our patient education website, will help us achieve this critical goal.”

Source: American Association of Clinical Endocrinologists