Expert: Ryan Hale - 12/9/2011

Question
Hello,

I am a type I diabetic who is very concious about eating food. Last summer I lost 10 kgs by playing sports and eating 1200-1400 calories aday. I am at college now in a different country doing medicine and my life has changed tremendously; I dont work out as much (1.5 hours per week , very little compared to previous excercise level and my insulin levels have increased by 6-8 points but I do alot of studying and work at college. My diet these days is about 1200-1600 calories , I eat cheese, dairy, vegetables and fruit (have been eating diabetic chocolate for the last week though), -carbs like pasta, flour .. are all excluded from my diet) .. and if I get the chance to eat fish or chicken I do eat .. however Ive had irregular menstrual cycle and didnt have it for almost 8 months now, my body is weaker because I noticed that I cant push doors to open sometimes and need to try hard, whenever I eat *anything I get stingy feeling on my face and I crave some food at times ( sugar and pastries) so Ipurge by chewing and spitting (it's been frequent recently). For the last week Ive been making soups for myself from organic stock cubes and eating tomatoes . Today I woke up with edema and I went to the doctor because I got very scared, he checked my urine for protein but there wasnt which is good, but my feet are swollen and I am worried, can it be related to any of what Ive mentioned above?

Thanks,
Nadia

Answer
Nadia- one of the very best ways a diabetic can help themselves regulate their sugar/insulin levels is with regular exercise.  I can understand how difficult it is to find time to exercise in your medical program, having gone through 2 graduate programs myself.  Remember though, if you use your intellect in your career, then you are your instrument.  That is to say, you have to take care of you!  So finding time must be a priority.

As for your eating and non-eating behaviors, I find it troubling.  You seem to be straddling the line between having an eating disorder and being very close to one.  I would recommend talking with a counselor or mental health therapist to discuss all of the aspects of your life that may be contributing to your feelings about yourself and food.  I'm not sure how easy a therapist is to find in the U.K. in the States they are all over the place (probably because we are so wacky here and need it).  There may be one on staff with your school and I'm sure there are some involved with your hospital.  

There are many things that could cause the swelling.  One of them that comes to mind is cardiac output.  As a diabetic and as someone who has restricted food intake at times, you are at particular risk for heart disease.  Although I'm guessing you are pretty young, it is still a very important thing to keep in mind.  You need to make sure that you are fueling your body with enough energy to do your activities...the heart is a muscle and its beating is an activity.  Most anorexics die of heart failure due to electrolyte imbalance.  Couple that with your higher risk of heart disease due to diabetes and that could be a problem.

Remember, it's better to eat some carbs, that are usually off your list of consumable foods, than to go without food(especially as a diabetic).  It may also be helpful to speak with a nutritionist to get his/her suggestions.