humulin-s and Diabulimia

Unique to individuals with insulin-dependent diabetes mellitus is a disordered eating behaviour whereby insulin is deliberately restricted or omitted. Despite growing research in this area, experiential perspectives of individuals remain understudied. Therefore, this meta-synthesis sought to explore the experiences of individuals with Type 1 Diabetes Mellitus by identifying, analysing and synthesising existing knowledge concerning this misuse of insulin.. Meta-aggregative techniques were employed to generate synthesised findings related to individuals' understanding and experience, physical and psychological impacts, support and treatment-related needs, noted in twelve studies.. A multifaceted relationship with insulin misuse, beyond weight control was identified. Many individuals experienced diabetes-related complications alongside increased distress, loss of control and feelings of regret, guilt, and shame. Almost all individuals valued support from those who shared a 'diabulimic' identity; peer support appeared more conducive to recovery than support from others including formal support services.. This meta-synthesis highlights the need for empathic, collaborative care, and proactive prevention and intervention. The findings highlight the value of peer support, the need for increased knowledge among informal supports, training among multidisciplinary teams and support services, and crucially the development of evidence-based treatments informed by the behaviour as a unique distinct construct.

Topics: Diabetes Mellitus, Type 1; Diabulimia; Feeding and Eating Disorders; Humans; Insulin; Insulin, Regular, Human

Poor adherence leads to worse glycemic control and increased complications in patients with type 1 diabetes mellitus (T1DM). Diabulimia characterizes patients with T1DM who skip or use less insulin for weight loss purposes. The study objectives were to determine: (1) the prevalence of diabulimia among adult patients with T1DM, (2) compare patients with and without diabulimia, and (3) identify factors that may place individuals at higher risk of diabulimia.. A 40-item, web-based survey was administered to 21 T1DM discussion boards, Listservs, and social media outlets. The survey assessed demographics, diabetes management, psychiatric diagnoses, and screened for diabulimia. Individuals who reported intentionally skipping or using less insulin than directed for the purpose of weight loss or to prevent weight gain in the past 12 months were classified as having diabulimia.. Of the 225 participants who completed the survey, 8.9% had diabulimia. Patients with diabulimia had elevated hemoglobin A1C (A1C) levels (8.4% vs 6.9%; P = .014), higher rates of a diabetes-related emergency department visits or hospitalization (30.0% vs 13.2%; P = .042), and higher rates of a major depressive disorder diagnosis (40.0% vs 11.5%; P < .001) than patients without diabulimia. Factors associated with diabulimia included high A1C levels (odds ratio, 1.43; 95% CI [1.08-1.91]; P = .014) and a major depressive disorder diagnosis (odds ratio, 4.87; 95% CI [1.31-18.22]; P = .018).. Approximately 1 in 11 adult patients with T1DM screened positive for diabulimia. Higher A1C levels and a diagnosis of major depressive disorder were associated with diabulimia.

Topics: Adult; Depressive Disorder, Major; Diabetes Mellitus, Type 1; Diabulimia; Feeding and Eating Disorders; Glycated Hemoglobin; Humans; Insulin; Insulin, Regular, Human; Weight Loss