I suggest orange juice, drinking the quantity your body normally needs to get back to a normal blood glucose level. Don’t worry about being perfect. Aim for 120-160 mg/dL so you know it is taken care of.

 

If you feel yourself wanting to eat more, then have a low carbohydrate snack that you can follow-up with and eat slowly. Remember to retest 15 minutes later. The ADA says, “If SMBG 15 min after treatment shows continued hypoglycemia, the treatment should be repeated. Once SMBG glucose returns to normal, the individual should consume a meal or snack to prevent recurrence of hypoglycemia.”1

 

For the “high to very high risk” categories, follow the same plan as the medium level with the following change: retest every 10 minutes and adjust accordingly.

 

Use orange juice when available. You will need to drink a little bit more than the amount for a medium risk bingeing because you are at a higher risk of going into a diabetic hypoglycemic coma when you go below 40 mg/dL. Drink the quantity your body normally needs to get back to a normal blood glucose level. Stay calm!

 

Next, get a second small glass of orange juice or, for variety, have a small glass of lemonade (or another sugary drink) that you can sip while waiting out the hunger. Distract yourself by calling a friend or watching a TV program you like or anything you can do to take your mind off the reaction. Do NOT go to sleep.

 

Vegetables are a good snack to curb the hunger. Make sure what you pick is something that you will really enjoy (if your cholesterol is normal, some dressing to dip them in would be good to satisfy the cravings). Be creative.

 

A low carbohydrate protein would be another good choice. I tend to favor an 1/8th pound of tuna fish salad that I eat with a small fork. Eat your snack slowly. Have it ready. I get pre-made tuna fish salad at the grocery store. If I don’t have a reaction that week, I have it for lunch before it goes bad.

 

Harm Reduction

The biggest problem with bingeing is the destabilization of your blood glucose levels.

Let’s work on preventing this.

 

When you end up bingeing, now what? Now you have one important task to do during this period of time. Keep paper and a pen on the refrigerator door.

 

When you take out the big tub of ice cream or whatever you are choosing to eat, scoop out or take out one serving at a time and write out the carbohydrates you’re eating as you go along. Do not eat out of the tub or package. Total them when your binge ends. Next, take fast-acting insulin to match what you just put in your body. You may feel sick from eating too much, but when everything is said and done, you will hopefully end up with a glucose level between 120-160 mg/dL instead of 400 mg/dL.

 

Conclusion

Diabetic bingeing is a physical response to the brain when it receives conflicting information about the status of the stomach and the need to eat. Messages of hunger hijack the human brain as long as your blood glucose levels remain low.

 

There are two ways to handle this hijacking and the binge that follows: one way is to prevent the binge and the other is to reduce the harm when a binge occurs. After the reaction is treated, binge prevention techniques can be used to suppress the false messages of hunger that are caused by low blood sugars. This can be done by slowly eating foods that are low in carbohydrates such as vegetables and diverting the attention away from the remaining thoughts of hunger through activities such as talking to friends or watching a movie.

 

Harm reduction allows the binge to occur but utilizes carbohydrate counting to maintain normal blood sugars after the binge and reaction subside.

 

Overall, bingeing is not good for anyone, but it is quite normal for people with diabetes when blood glucose levels drop and cause hypoglycemic reactions. All people with type1 diabetes will go through many reactions in a lifetime, but you can reduce the number of binges and find comfort in the fact that it is a physical issue and not fully in your control.

 

My therapy practice was created to help anyone living with diabetes. If believe you might be struggling with Binge Eating and need help, Please call (917) 272-4829 for more information or to schedule your first Diabetes-Focused Psychotherapy® Session.

 

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Medical Disclaimer:

All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.

Reference:

1.  American Diabetes Association. (January 2011). Standards of Medical Care in Diabetes-2011, Diabetes Care, Volume 34, Supplement I. care.diabetesjournals.org.

 

Sources

• American Psychiatric Association. (June 2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. [DSM-IV-TR]. Washington, DC: American Psychiatric Association.
• American Dietetic Association ( April 2008). Your Digestive System and How It Works, NIH Publication No. 08–2681Chicago, IL: http://digestive.niddk.nih.gov/ddiseases/pubs/yrdd/#control 
• National Geographic Society. Digestive System, National Geographic: http://science.nationalgeographic.com/science/health-and-human-body/humanbody/digestive-system-article/
• Takako Hara (spring 1997). Hunger and Eating, California State University, Northridge: http://www.csun.edu/%7Evcpsy00h/students/hunger.htm
• Jane Kirby, RD and The American Dietetic Association, How Your Brain Signals Your Body's Need for Food, For Dummies, http://www.dummies.com/howto/ content/how-your-brain-signals-your-bodys-need-for-food.html
• James W. Kalat (2009), Biological Psychology Tent h Edition, Module 10.3 300-313, Belmont CA: Wadsworth Cengage Learning

 

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