I Sent My Body into Meltdown to Be Slim

By STEPHANIE RAFANELLI

WHEN Caroline McGovern was diagnosed with Type 1 diabetes at the age of 12, she was appalled by the restrictive diet that the condition forced upon her.

But Caroline, now 27, soon realised that by not taking the insulin shots vital for stabilising her blood sugar levels, she could actually lose weight while eating exactly what she wanted. While the drastic measures she took gave her the body she desired, the horrifying legacy of her behaviour only fully dawned upon her last year, when she was told that she needed a double pancreatic and kidney transplant.

A third of young female diabetics are skipping vital insulin jabs, it was revealed last week, in an attempt to lose weight.

‘Diabulimia’ can result in devastating longterm side-effects, and it has sparked a new debate about the serious psychological effects of diabetes for teenage girls.

Weight gain is a common side-effect of taking insulin shots to control Type 1 diabetes. But in neglecting to take insulin, an estimated 3,000 teenage girls and women in their early 20s are inflicting serious damage on their bodies, including blindness, nerve damage, strokes and kidney failure.

Diabetes is a long-term condition that affects the body’s ability to produce insulin the chemical that regulates blood sugar levels and converts glucose to energy in the body’s cells.

No foods are forbidden for diabetics, but they must follow a healthy balanced diet to keep blood sugar levels as normal as possible.

Type 1 diabetics need to strictly monitor their timing and intake of carbohydrates especially those with a high Glycaemic Index, which quickly release sugar into the blood.

‘In Type 2 diabetes, the pancreas’s insulin emissions are reduced and the body slowly becomes insulin resistant, but in Type 1 the organ suddenly stops producing insulin,’ explains Dr Sarah Jarvis, spokeswoman for women’s health at the Royal College of GPs.

Type 1 diabetes is a genetic condition thought to be triggered by a simple infection or even by hormonal changes during puberty.

Warning signs include lack of energy, extreme thirst, a constant need to urinate and a sudden drop in body weight.

AND it is the last symptom that is igniting the interest of some teenage girls.

‘What initially appeals to young girls is the rapid weight loss that accompanies Type 1 diabetes,’ confirms Caroline Butler, care advisor of Diabetes UK. ‘The problem is that once a young diabetic starts using insulin, it is normal that she will gain weight as the body regains its ability to process sugar and release energy to cells.’ The link between Type 1 diabetes and eating disorders was first highlighted in 2000, when Canadian research found that young women with Type 1 diabetes who used insulin were 2.4 times more likely to have an eating disorder than non-diabetics.

This tendency may partly be due to the fact that Type 1 diabetes is most commonly diagnosed during puberty in girls aged 10 to 14.

The burden of controlling the illness is compounded by normal hormonal changes and the increasingly obsessive preoccupation with body image, particularly the celebrity ‘size zero’ phenomenon, in which girls attempt to achieve the equivalent of a UK size 4. Caroline McGovern, from Enfield in Hertfordshire, a project officer at Haringey Council, was diagnosed with Type 1 diabetes after losing half a stone in under a week.

At 5ft 3in, she plummeted to 6st, but quickly regained the weight when she began her complex insulin programme. By the age of 14, Caroline’s weight had jumped to 10st. She says: ‘I was tired of sticking to my restrictive diet and I started rebelling by bingeing on chocolate. I had to take more insulin to compensate for all the glucose I was eating, so my mum didn’t know I was bingeing, and that made me put on more weight it was a vicious circle.’ Insulin increases the tendency to gain weight by lowering blood sugar levels, which may in turn increase food cravings and the chances of a serious sugar low or hypoglycaemia.

During an attack, some diabetics may also be tempted to binge in order to raise levels in the blood.

Responsible for their own strict regime of insulin injections, young diabetic women learn how to control their weight by reducing their shots.

With less insulin, the body is unable to covert glucose into energy, leading to light-headedness and a constant need to drink and urinate, as the body attempts to flush away dangerously high blood sugar levels.

Between the ages of 14 to 22, Caroline skipped at least two of her four insulin doses a day, giving herself only enough insulin to stop herself slipping into ketoacidosis, where the body reaches starvation levels, starts burning muscle and protein and releasing ketones into the blood, which can lead to a life-threatening coma.

She dropped two stones while managing to hide her insulin abuse from her parents, ‘tricking’ blood sugar level tests by not putting enough blood on the test strip to get an accurate reading.

Caroline ran ‘high’ for eight years, with consistently raised blood sugar levels. ‘I was always too lethargic to do anything, but after a while you get used to functioning that way.’ At her worst, Caroline was admitted to hospital every six to eight weeks, always on the verge of ketoacidosis. ‘I didn’t care because the buzz of losing weight always outweighed the symptoms of running high,’ Caroline says. Dr Jarvis says: ‘The short-term sideeffects of high blood sugar are such that you can function over a long period of time as long as you can avoid going into a coma.’ But the consequences of sustained high blood sugar levels include damage to blood vessels in the eye, which can lead to blindness, and kidney failure due to an overload of glucose in the body. Other problems are neuropathy nerve damage which can lead to limb amputation strokes and cardiovascular disease.

At 25, Caroline’s health began to deteriorate rapidly. One by one, her list of diabetic complications due to her insulin abuse emerged: she was diagnosed with damage to the involuntary nervous system, due to nerve damage in her heart, causing dizziness and high blood pressure.

Her eyesight began to fail due to retinopathy, she had nerve damage in both feet, gastroparesis (a delayed emptying of the stomach) and her teeth rotted from the fizzy drinks she had drunk to quench her thirst. In February 2006, Caroline was told that her kidneys were failing.

SHE would need a double pancreatic and kidney transplant. In March 2007, after six months on the waiting list, she underwent transplant surgery at Oxford’s John Radcliffe Hospital, and is now in diabetic remission.

In theory, this means that with dosages of immunosuppressants to prevent her body rejecting the organs, her new pancreas will produce insulin and she will never have to inject it again. But her new organs could fail at any time and she will have to take anti- rejection drugs for the rest of her life.

Caroline says: ‘I feel so guilty that I abused my body and brought this on myself. But above all, I am shocked that this happened to me so young.’ This vulnerability may be heightened by the pressures of puberty or a traumatic event.

Jo Kennedy, 31, a former retail manager from Surrey, was diagnosed as a Type 1 diabetic when she was four. At 13, she stopped taking her insulin injections after her mother died of a heart attack, and was taken into care.

Jo says: ‘There’s a lot of responsibility on you as a diabetic to self-medicate, but as a teenager you don’t want to look after yourself.’ Jo was bullied at school for being diabetic. She was nicknamed ‘jabby’ and was asked if she was pregnant due to lipohypertrophy, a build-up of fat tissue around her stomach caused by injecting the same site.

When she suffered from mood swings and lack of concentration, no one recognised the cause of her symptoms. She was labelled a ‘problem child’ and left school without qualifications.

She ran ‘high’ until she was 17, when she met her future husband, John, from whom she is divorced.

She lives on incapacity benefit due to the crippling nerve damage in her limbs, is at risk of going blind and suffers from kidney damage.

Jo says: ‘I am a size 16 because of my ailments and the fact that I am virtually housebound. Girls may want to be skinny, but in the future they might end up like me.’ Diabetes UK is campaigning for more transitional care clinics around the country, to help teenagers deal emotionally and physically with diabetes.

FOR more information, call Diabetes UK Careline on 0845 120 2960, or visit www.diabetes.org.uk

(c) 2007 Daily Mail; London (UK). Provided by ProQuest Information and Learning. All rights Reserved.