When David Stephens was told he had diabetes - little did he know it would lead him to having an eating disorder.
As he struggled to cope with the daily pressures of managing his condition, he started obsessing about the side-effects of taking insulin and then stopped taking it altogether.
Little did he know he was suffering with diabulimia - an eating disorder which affects as many as four in 10 women, and one in 10 men, with type 1 diabetes aged 15 to 30.
"Throughout my childhood I was always seen as this slim guy. Weight was never an issue for me," said David.
"But when I began taking insulin for my type 1 diabetes I had this terrible fear about putting on weight. It really scared me.
"I stopped taking one of my two forms of insulin to try and lose weight. That went on for about 18 months and it was quite dangerous.
"At the time I didn't know I had a recognised mental health condition."
David, of Newport , said his dad was the first person to spot his diabetes symptoms - which includes drinking a lot of water and going to the toilet more frequently than normal.
His weight also dropped from a healthy 9st to an underweight 7st.
"It was summer and I thought it was just down to the weather. The out-of-hours doctor diagnosed me there and then," said David, whose blood sugar reading was 10 times the normal level.
“I didn't really understand it. I was told 'you've got to have injections for the rest of your life'. But it’s a lot more than that.
"It wasn't until a couple of months later that I started to understand that this was going to change my life completely."
David said he felt completely overwhelmed by the relentless demands of managing his diabetes.
Food, exercise and even hot weather can all lead a diabetic's blood sugar levels to become imbalanced.
"There was so much information to take in. It was really daunting," added David.
"I’ve got to make sure my blood sugars are okay, that I’m doing my injections on time, that I’m eating the right amount of food.
"If my blood sugar level was high I’d feel like a terrible person. It’s relentless and most of the time you have to manage it alone."
Two years after being diagnosed, David said his mental health also began to suffer.
"At 21 it all caught up with me. I’d put on a brave face when in reality it was eating away at me.
"I’d had a life before diabetes and I resented it."
David admitted he did not like the way he looked when he began returning to his normal weight.
"I would look at myself in the mirror and was convinced I was getting too big, but my friends and family would tell me I wasn't."
He said as well as having diabulimia, he'd also "overdose" or "insulin stack" when he was worried about his blood sugars not reducing quickly enough.
"I tried to explain to my diabetes team that my insulin regime wasn’t working for me," he said.
"They referred me to my GP who suggested counselling. But I knew that wouldn’t be enough.
"They wouldn’t understand what I was going through because it was so closely linked to my type 1 diabetes."
David, now 28, later turned to alcohol to cope with how he was feeling.
"I found alcohol lowered my blood sugar. At my lowest point I was out drinking four times a week.
"My diabetes team said they would put me on a diabetes education course but I would have to wait, so I just drank more. I was scared to tell them what was really happening."
Thankfully, David found an online community for people with type 1 diabetes - which he said helped him through his darkest period.
"To begin with I found it hard to interact and open up about what I was going through," he added.
"But now I thrive thanks to that community. If I need something they’re always there.
"A peer support group with other recently-diagnosed people would have been a massive help at the time. We would have all been going through it together, and that forms a support network.”
Three years ago he was given a diabetes pump, which is attached to his arm and allows him to regulate his own insulin dosage without the need of injections.
"The pump has changed my life completely," he added.
"If I'd had it sooner it may have stopped me from having diabulimia altogether.
"I'm now able to travel more and not worry so much about my condition. I would also get a lot of funny looks when I would inject in public. People thought I was doing illegal drugs."
He said that diabetics' mental health as well as their physical wellbeing should be taken into account by doctors and nurses.
"I’m on a waiting list to see a psychologist, but it’s not a diabetes psychologist so I’m not confident that it'll benefit me," he added.
"You need to speak to someone who has that specific understanding about your condition and how its affecting you mentally."
How a Welsh family's life was turned upside down by diabetes
Diabetes UK Cymru said David's story was not a unique one.
The charity's public affairs manager Josh James said: "Type 1 diabetes is much more than a physical condition.
"Monitoring blood glucose, injecting insulin, taking medications, and trying to follow a healthy diet can be tough.
"The relentless need for self-management can have a profound impact on emotional health, but there is currently huge variation on delivering psychological support to those with a long-term condition across Wales
"This leaves people like David struggling to access the support which could make a vital difference."
Diabetes UK has a dedicated and confidential helpline for all people with diabetes, their family or friends, or those worried they might be at risk. Call 0345 123 2399 or email helpline@diabetes.org.uk
More more information on diabulimia go to https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/diabulimia
