Many type-1 diabetics rely on insulin to manage their blood-sugar levels. Without it, diabetics can suffer from dehydration, fatigue, blurry vision, and, over time, weight loss.
For some, however, the weight loss is exactly what they're going for, and they'll actually skimp on their insulin in order to achieve this.
It's called diabulimia.
The condition isn't a clinical diagnosis, but it's becoming scarily more common among type-1 diabetics — mainly women.
Diabetes.org.uk estimates that "40% of all women between the ages of 15-30 with type-1 diabetes give themselves less insulin in order to lose weight."
The website also states that female type-1 diabetics are twice as likely to develop anorexia or bulimia, and 60% will have a "clinically significant" eating disorder by the time they turn 25, according to research from the University of Toronto.
Eating disorders are dangerous for everyone...
...but especially for anyone with a chronic health condition, like diabetes. Not getting the right amount of insulin leads to diabetic ketoacidosis (DKA), which can lead to blindness, limb amputation, and death.
Broadly recently told the story of Rebecca Ryan, a young woman whose diabulimia caused her eyes to bruise and swell and landed her in the hospital.
"It's awful because you know the consequences of your actions ... but none of that stuff seems to matter," Ryan said.
So, why type-1 diabetics?
"Because both diabetes and eating disorders involve attention to body states, weight management, and control of food, some people develop a pattern in which they use the disease to justify or camouflage the disorder," according to the American Diabetes Association.
Diabetics have to maintain an incredible amount of precision and control when it comes to monitoring their food and vital signs. This feeling of powerlessness or even being "failed" by one's body could lead to their desire to exert control in other ways, an an eating disorder is an effective, albeit dangerous, way to get back some of that control.
It's crucial that health professionals talk to their patients about the risks of restricting insulin, and that those suffering (as well as their family and friends) get the care that they need, physically and mentally, if diabulimia is something that they are struggling with.