WA health experts are worried that a third of young women with diabetes risk limb amputation and kidney failure by skipping their insulin to stay slim.
Diabetes WA says diabetes is Australia's fastest-growing chronic illness, with almost one million people diagnosed, and insulin manipulation is one of the most common eating disorders in people with type 1 diabetes.
Known by some as "diabulimia", it involves limiting or skipping insulin injections to lose weight, which puts the body into starvation mode and results in muscle and fat breaking down and weight loss.
Research suggests 30 per cent of girls and women with type 1 diabetes restrict their insulin at some time in their lives, trebling their risk of early death.
Without insulin, glucose cannot enter cells to be used as energy passes out of the body in urine, causing high blood glucose levels. Complications over time include heart and eye problems, nerve and kidney damage, and damage to limbs requiring amputation.
Diabetes educator Sandy Havlin said young women were known to miss an insulin dose to lose weight. For others it was a way to have some control over a condition which they resented having.
"If they withhold insulin, glucose gets trapped in the bloodstream and can't get to cells to be used as energy so the body has to use fat and protein to provide a secondary source of energy, and that's why they lose weight," Ms Havlin said.
"But when fat breaks down to use as energy the by-product is ketone which is very acidic in nature and changes the biochemistry of the blood, and if not attended to, people can die."
Jayne Ross, 37, has paid a heavy price for manipulating her insulin doses when she was younger, having a leg amputated below the knee two years ago. She is now battling kidney disease.
The mother of two said she started altering her insulin dose when she was 15, mostly to lose weight. It was only when she was in early 20s that she realised the damage she had done.