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 !


How Was Your Long Weekend?

Sometimes our work demands can take a toll on us. Our employer’s requirements impacts our personal schedules, our time spent with our loved ones, and our own personal time. Thus, the anticipation of a long weekend may contribute to thinking “down time” or “it ‘s a great time to do absolutely nothing!”.

The traditional time spent with family around a table filled with food is sometimes just enough to celebrate the “hype” of thanksgiving. Jeff posted this past Friday about the history of thanksgiving as celebrated by communities coming together and appreciating each other’s value.

Yes, the time spent with our families sometimes is just enough. Furthering growth and development with our family members, however, may require us to do more; such as reaching out to our friends that we only speak to once or twice a year, volunteering at a local shelter or organizing a non perishable collection with the members of our family, neighbourhood or local church.

When we want to enhance the relationships with our family members and significant others, it often involves doing more than the usual. It may also be engaging in enriched conversations about how to support each other in pursuit of our fullest potential.

Stepping out of our comfort zone tends to be a little easier when we have the support of our family, friends, and our community. Taking baby steps can help as long as we recognize that falls are common. Why not consider a whole host of ways to celebrate various holidays… while helping others at the same time?

Thankfulness is good for mental health

Having an attitude of gratitude and genuinely being appreciative for what we have is healthy. The recognition that we have benefited from something outside of ourselves inspires both humility and thankfulness. In the depiction above, titled The First Thanksgiving at Plymouth” (1914) by Jennie A. Brownscombe (1850-1936) , we see early Pilgrims and American Indians sharing the first Thanksgiving together, having helped each other with the harvest.

Certainly we can be thankful for anything, such as health, work, education, family, friends, sport, romance and love. The traditional and historical roots of thanksgiving celebrations, however, rise out of a deep appreciation and thankfulness for the harvest of food; cupboards and pantries filled with sufficient supplies to sustain life until the next growing season.

In North America, Thanksgiving Day was proclaimed* formally as follows;

On Thursday, January 31, 1957, the Parliament of Canada proclaimed:
A Day of General Thanksgiving to Almighty God for the bountiful harvest with which Canada has been blessed – to be observed on the 2nd Monday in October.


Thanksgiving Day, is a holiday celebrated in the United States on the fourth Thursday in November. It has been an annual tradition since 1863, when, during the Civil War, President Abraham Lincoln proclaimed a national day of “Thanksgiving and Praise to our beneficent Father who dwelleth in the Heavens”, to be celebrated on Thursday, November 26. *From Wikipedia, the free encyclopedia {emphasis added}

Although it appears our American neighbours’ observance of thanksgiving predates ours in Canada, Wikipedia goes on to report “The history of Thanksgiving in Canada can be traced back to the 1578 voyage of Martin Frobisher”. Martin and his crew were thankful for surviving the icy waters to the north, where some did not.

Enough history? What about thankfulness and mental health?

Citing research from Robert Emmons’ new book Thanks!: How the New Science of Gratitude Can Make You Happier (Houghton Mifflin, 2007) Bruce Campbell reports:

“Summarizing the findings from studies to date, Emmons says that those who practice grateful thinking “reap emotional, physical and interpersonal benefits.” People who regularly keep a gratitude journal report fewer illness symptoms, feel better about their lives as a whole, and are more optimistic about the future. Emmons conclusion is that gratitude is a choice, one possible response to our life experiences.”            (from:

Giving thanks has been healthy since the beginning of time. Practicing an attitude of gratitude takes work. Positive psychological approaches, like mindfulness, narrative re-writing, solution-focused and cognitive-behavioural therapy help people more fully develop healthy and positive mindsets. It may not surprise us to learn that thankfulness, as with most positive psychological approaches, has its origins in ancient religious teachings.

Helpfulness and altruism share these spiritual origins and also contribute positively to our mental health. This Thanksgiving, when we are giving thanks for what we have at our table, it is equally important to help those in need. Our native American Indians and Pilgrims to the south helped each other survive and were understandably thankful.

“No matter what struggle, challenge or issue we are facing it seems wise to direct our focus on what we are thankful for. In addition, helping those who are less fortunate is a healthy, outward extension of our thankfulness.”

Genuine thankfulness and altruism can take more strength, more energy and more grace than we have. This may be precisely why the pioneers of thankfulness along with our world leaders chose to extend their thankfulness to God.

Happy Thanksgiving!


While it sure is great to be employed, it is also important to take holidays for restoration and rejuvenation.  Planning for a holiday can add stress to our already busy lives, however, taking a little time to plan generally enhances your holiday experience.  With a bit of thoughtful preparation we can reduce risks, prevent unwanted surprises, and improve the odds of having the vacation experience we desire.

Funny how we sometimes put more effort into planning a vacation than we put into planning our lives; relationships, family and career goals.

Thinking ahead, budgeting and negotiating goals are a few areas to address. It is also important to take time to carefully consider the qualities we want to develop in ourselves and in our relationships with our spouses/partners, children, family and colleagues. It may be a good practice to intentionally do this on our holidays.

Some of us may do this already, taking stock of both our intrapersonal and interpersonal relationships and challenging ourselves to find tools to improve our walk with those closest to us.

We can use our holidays travelling for R&R and also for… charting out paths to improve our journey in life.


Atop Booth Rock at Rock Lake, Algonquin Provincial Park