Managing Type 1 Diabetes is Complex!

People who have type 1 diabetes spend significant energy and time considering food, eating and energy expenditure (note: type 1  is totally different than type 2 diabetes). Paying close attention to carbohydrate intake helps more effectively determine how much insulin to take.

In addition, people with insulin-dependent diabetes check blood sugar levels regularly (between 4 and 8 times per day minimum = 1400 to 1600 X per year), and account for many other variables in order to accurately calculate the amount of insulin to be injected.

Insulin works to pick up glucose (sugar) from the blood and carry this throughout the body, providing energy to the cells. Higher blood sugar levels can lead to urinating frequently, flushing important nutrients, contributing to weight loss.  This means a person with Type 1, who does not get enough insulin will drop weight, be able to eat extra food without gaining weight or a combination of the two; eat more and even lose weight. 

Diabulimia – a rare eating disorder

The term refers to people with type 1 diabetes managing weight and body image issues through missed or reduced dosing of insulin. Research indicates prevalence rates close to 30% of people with type 1 diabetes. This disorder impacts both genders and all ages, however, there are increased prevalence rates among adolescents and females as is true with most eating disorders.

Informally named diabulimia, this disordered eating behaviour (DEB) can be quite harmful and disruptive to the daily functioning for people managing type 1 diabetes.  While this behaviour may involve intentional insulin omission, this may not always be the case. Science has more recently helped us think of the stomach is like a second brain. We also know the body and mind can develop habits that are not necessarily driven by conscious thought.

Given this knowledge, it is very important to refrain from blame in efforts to help those with this highly addictive behavioural pattern. Imagine if you could eat all kinds of food, much more than your friends, and through missing insulin not gain any weight? No purging, excessive exercise, laxative use or other behaviours required.

It is very important to watch for the following symptoms of diabulimia

  • Frequent urination
  • Excessive thirst
  • Increased appetite, even binging behaviours
  • High blood glucose levels (HBA1c often higher than 10)
  • Lower energy levels
  • Lower sodium levels
  • Headaches
  • Difficulty concentrating (increased work or school challenges)
  • Severely imbalanced ketones
  • Increased mood swings (agitation, grumpy)


  • images-1If these sound familiar for you, or someone you know, it is important to seek professional help from specialized, multi-disciplinary diabetes teams which include, nurses, dietitians, doctors, social workers and others. A team approach works best for any eating disordered recovery.

Working together, the person with type 1 diabetes can develop healthier management techniques, eating patterns and mental health strategies to improve health. Including other family members can also increase the healthcare team and speed up recovery from this difficult and rare disordered eating behaviour.

For more information contact us today !


Sometimes a new diagnosis for your child may release certain feelings: guilt, shame, embarrassment, or regret. We might tend to push these feelings aside and focus on the “main concern,” that being our child. Getting counselling or therapy help for our children is great, yet, this is not necessarily the only strategy for our family’s overall health and improvement.

Family systems theory points to the interconnectedness of all family members. We don’t always feel connected so how is it family members are connected? This “umbrella” theory suggests that we are connected by the vast array of rules and roles members have in the family and also by the emotional intensity so apparent in family relationships. Following this, one person’s diagnosis then impact us all, thus, is actually kind of a diagnosis for the whole family. 

This is a very positive and optimistic perspective that implies a change in one part of the system or family member will actually change all members. A difficult concept given all the negative press or thinking that states you can’t change other people.  False!  According to the science behind family systems theory we can. In therapy or counselling, when one person comes in to improve (thoughts, feelings and behaviours), we can expect to gradually also see a change in others in the family.

Rather than just wanting one person to get help, we may want to include as many family members as possible in the counselling or coaching process. Thinking systemically requires us to acknowledge that a health diagnosis, major event or situation can and will have an impact on the entire family.

We at Jeff Packer MSW & Associates Inc. encourage all family members to join counselling sessions when and where appropriate, while also understanding one person can begin the process.


  1. By addressing the impact of the diagnosis for the entire family, it provides a better understanding of each member and the role they play in their family system.
  2. The more family members work together on solutions, the faster and more effectively we can adjust and/or improve.
  3. Increasing the communication of the diagnosis can create a stronger support system for the person diagnosed.
  4. Because family members have a profound impact on each other’s thoughts and feelings, learning how to cope with the negative thoughts and difficult feelings will create unity and promote teamwork.

Invite as many family members as you want, yet be ok to start the change process on your own. Remember, change is happening all the time. Our decisions influence the direction of change; either toward better or worse relationships. To change for the better... contact us today !

Fighting off Type 1 Diabetes, day in and day out, is the job of a super hero!

Short of wearing the cape, (and some do as above…lol), people who have type 1 diabetes are doing what any good super hero would do.  Those with insulin-dependent diabetes expend amazing amounts of energy to stay on top of the tasks necessary to fight off the evil diabetes.  Most notably, these super heroes are required to inject insulin multiple times every day to stay healthy and alive.

After all, isn’t that what super heroes do… save lives. They also fight off injustice and any chronic, life-threatening illness certainly isn’t fair or just. Yes these things happen, but, can you tell a little five year old who has just been told she has diabetes this is fair? Now she is to learn how to calculate the carbohydrate amount for every and all food so she can calculate insulin doses.

images-1Whether she is five, fifteen or forty-five, she and her family members are now thinking almost constantly about life-saving decisions; carb calculations, exercise and activity levels, medications, stress levels, sites to inject next time, where to store the supplies, how to keep them available everywhere and what to say to friends, family and complete strangers when she pokes her finger to check her blood sugar or glucose levels. Super hero indeed!

The next time you hear of or see someone who has type 1 or “insulin dependent” diabetes, consider letting them know how amazing it is that they are fighting off the evil diabetes to save their life and combat injustice. 

To all who have type 1 diabetes… or “liveabetes” as one child called it… keep up the fight!

Diabetes fighting man from Alderville school calendar 2005

Gettin Rid of “Stinkin Thinkin”

Imagine your brain like a massive hard drive, super storage space, maybe a gazillion terabytes (that’s a lot of stuff on our minds). What do you think is on it at birth?  How much information is on the brain of a newly born baby? The philosopher and teacher David Hume called the mind at birth a “blank slate”. I’ve simply upgraded this to be the “virtually blank harddrive”, virtually because of some in vetro experiential loading in the womb.

Every input from the second we’re born… through our eyes, ears, nose, mouth and every nerve loads onto our brain. This super fast processor receives data from parents, family, extended family, media like TV, books and the internet, pets, nature, on and on. Brain or neuroscience experts suggest we don’t really forget as much as we have storage and retrieval challenges. Tough to keep all that data in the front of our hard drive.

Amazing to think about. Everything we see, taste, smell, touch, feel and hear stored in the “background” with very little on the desktop so to speak.

Wow! So much data. How we organize it from early on in our lives, whether consciously or not, begins to shape our thought patterns, schemata, constructs which then shape our emotions and moods. Together thoughts and feelings then drive our behaviour, this is simply going on in the background of our mind.

Computer Head

To think almost all the information loaded on our hard drive comes from elsewhere. Why do we quite often believe all the thoughts in our head are our own? Why do we quite often believe all the thoughts in our head are our own? This is perhaps my favourite question! That’s why I asked you twice.

If this analogy holds true then consider that we may also call the negative thoughts a virus, thoughts that spread, overshadow positive thinking, disrupt and infect healthier thoughts and files. Suppose it is possible to have a cognitive virus made up of all those negative, defeating words and phrases? I call this “Stinkin Thinkin”.

Through counselling that combines cognitive-behavioural therapy, we can effectively catch and “quarantine” out negativity.  At the same time, drawing upon narrative theory and re-writing of your story, our professional counsellors help people bring out their more positive thoughts and self which improves mood, emotional expressions and behaviour.

This counselling is a very effective therapy and can best be considered the first line of defence for those struggling with depression, anxiety, eating disorders, chronic health issues, addictions and most relationship issues. 

To find out how get rid of “stinkin thinkin” easier…  Contact us today




Many people think and feel that the diagnosis of diabetes is overwhelming, a catastophe, something that is almost insurmountable. These feelings and the thoughts that flood our minds during and shortly after a diagnosis of a chronic health issue are common and quite normal. Despite all the negative press and general attitudes about diabetes and “what can happen”, diabetes is one of the few chronic health conditions that is a “life sentence”. One four year old child actually called it “Livabetes”. He said, after hearing his mother cry and seeing his father’s stoic facial expression during the drive home from hospital… “I don’t have diabetes… I have livabetes because the doctors said I’m going to live a healthy life”.

Such a condition brings people into contact with doctors, nurses, dietitians , social workers and other PWDs (people with diabetes). Learning more and more each day, week and year about health, nutrition, the mind and wellness becomes the “life” of those fighting off diabetes. Picking up the tools and strategies to combat this villain – diabetes- becomes a part of everyday life “until a cure is found”. Yes diabetes is a life sentence… pointing out the importance of enjoying health, fitness and life in general… Tell others.

There are many strategies, books and resources to help those who have diabetes and their families.

Live a Long & Healthy Life "Until a Cure is Found"

Live a Long & Healthy Life

For more information; contact the Charles H. Best Diabetes Centre or go to your local diabetes care team / clinic.