Diabulimia

Ruth-Sahd, Lisa A.; Schneider, Melissa A.; Haagen, Brigitte

doi:10.1097/dcc.0b013e3181a473fe

Cited by 18 publications

(4 citation statements)

References 26 publications

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“…Diabulimia is a newly defined DSED that refers to the behavior of skipping insulin doses or administering insufficient doses of insulin in order to lose weight in individuals with T1DM [ 9 ]. Insulin restriction/skipping has been shown to be the most common behavior among patients with T1DM to lose weight after self-induced vomiting, excessive exercise and laxative use [ 10 ].…”

Section: Aimmentioning

confidence: 99%

Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus

et al. 2023

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Purpose It was aimed to investigate the frequency of the risk of diabetes-specific eating disorder (DSED) in adolescents with type 1 diabetes mellitus (T1DM) and to reveal the accompanying psychopathologies. Methods Adolescents with T1DM aged 12–18 who applied to the pediatric diabetes outpatient clinic between July 2021 and March 2022 were included. Diabetes Eating Problem Survey-Revised (DEPS-R) was applied to all patients to determine the risk of DSED. In order to detect accompanying psychopathologies, Eating Disorder Examination Questionnaire (EDE-Q), Child Anxiety and Depression Scale-Child version (RCADS) and Parenting Style Scale were applied. After completing the scales, semi-structured interviews were conducted with all patients by a child and adolescent psychiatrist. Results Ninety-two adolescents (45 boys, 47 girls) were included. DSED risk was found in 23.9% of the cases. A positive correlation was found between DEPS-R and EDE-Q scores (p = 0.001, rho = 0.370). RCADS mean scores were significantly higher in the group with DSED risk (p < 0.001). When the Parenting Style Scale was evaluated, psychological autonomy scores were significantly lower in the group with DSED risk (p = 0.029). As a result of the psychiatric interviews, 30 (32.6%) patients had at least 1 psychiatric disorder. Of these, 2 patients were diagnosed with eating disorder. Conclusion Almost one-fourth of adolescents with T1DM were found to be at risk of DSED. Routine screening of adolescents with T1DM with the DEPS-R scale may provide early detection of DSED, and referral of those at risk to child psychiatry enables early diagnosis and intervention for both eating disorders and accompanying psychopathologies. Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.

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Section: Aimmentioning

confidence: 99%

Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus

et al. 2023

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“…These patients quickly develop diabetic ketoacidosis, one of the most serious acute complications of diabetes, as a consequence of starvation the body begins to burn fat for energy [34]. Further on, it can cause problems with the absorption of macro -and micronutrients, leading to diseases such as malnutrition, anaemia, menstrual disorders in women or other hormonal disorders [35].…”

Section: Discussionmentioning

confidence: 99%

Comorbity of eating disorders and depression in T1DM patients: challenges and tasks for dietetician - a pilot study

Krzyżowska,

Cyranka,

Matejko

et al. 2023

Arch Psych Psych

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Aim of the studyThe aim was to assess the occurrence of eating disorders (ED) in type 1 diabetes (T1DM) patients being under regular diabetologist care, that qualify for a visit to a psychologist and to evaluate possible correlation of eating disorders with symptoms of depression and anxiety in this population.Subject or material and methodsThe study included a selected group of 27 adult patients (55.5%- women) with T1DM under the constant care at the diabetes clinic. The following tools were used: to assess depression and anxiety, used the Patient Health Questionnaire (PHQ-9) and Center for Epidemiological Studies Depression Questionnaire (CES-D); EAT-26 assessed ED screening and Mood Disorder Questionnaire (MDQ) – other problems.ResultsBased on the overall assessment of the EAT-26 test as many as 7% of group was problem, which manifested a high level of concern about dieting, body weight or problematic eating behaviors. Additional the 25.9% people reported high depressive. We showed a relationship between ED and depression.DiscussionThere was a similar frequency of eating disorders ED eating disorders have elevated glycated haemoglobin (HbA1c), however, in our study, the mean HbA1c was 6.85% (51 mmol/mol) - fairly good glycemic control. In addition, a correlation between ED and depression has been noted, and patients with type 1 diabetes are very sensitive to both disorders.ConclusionsPeople suffering from type 1 diabetes, due to the increased risk of eating disorders or depression, require comprehensive care of a therapeutic team, which should include a diabetologist, psychologist, psychiatrist, diabetes educator, nurse, nutritionist.

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“…Even in children and adolescents, depression has demonstrated distinct comorbidity with EDs ( Swanson et al, 2011 ), and levels of depressive symptoms have been shown to improve following weight gain in hospitalised eating disorder patients ( Sala et al, 2011 ). Depressive symptoms may also be experienced in patients engaging in IO, given that resulting hyperglycaemia is associated with low energy levels, poor sleep and trouble concentrating (( Ruth-Saad et al, 2009 ). Future research is necessary to further explore the causal relationship of depression on IO.…”

Section: Anxiety and Depressionmentioning

confidence: 99%

“…Research suggests that it may be as a method of weight loss ( Polonsky et al, 1994 ). Short-term symptoms of IO are those of hyperglycaemia: excessively high blood glucose (>11%), increased ketone levels, thirst, frequent urination, fatigue and cognitive deficits such as lack of concentration ( Ruth-Sahd et al, 2009 ). The longer and more frequent the IO, and the longer the hyperglycaemic state persists, the more severe the symptoms: weight loss, severe dehydration and increased glycosylated haemoglobin (HbA1c).…”

Section: Introductionmentioning

confidence: 99%

A review of risk factors associated with insulin omission for weight loss in type 1 diabetes

Hall

Keeble

Sünram-Lea

et al. 2021

Clin Child Psychol Psychiatry

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Research suggests that as many as 60% of people with type 1 diabetes (T1D) admit to misusing insulin. Insulin omission (IO) for the purpose of weight loss, often referred to as diabulimia, is a behaviour becoming increasingly recognised, not least since prolonged engagement can lead to serious vascular complications and mortality. Several risk factors appear to be relevant to the development of IO, most notably gender, anxiety and depression and increased weight concerns and body dissatisfaction. Evidence suggests that women, especially young girls, are more likely to omit insulin as a method of weight loss compared to men. Mental health conditions such as anxiety and depression are increasingly prevalent in people with T1D compared to their peers, and appear to contribute to the risk of IO. Increased weight concerns and body dissatisfaction are further prominent risk factors, especially given increases in weight which often occur following diagnosis and the monitoring of weight by diabetes teams. This review presents evidence examining these risk factors which increase the likelihood of a person with T1D engaging in IO and highlights the complications associated with prolongment of the behaviour. Further research looking at the comorbidities of these risk factors, alongside other factors, would provide greater insight into understanding IO in people with T1D.

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Diabulimia

Cited by 18 publications

References 26 publications

Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus

Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus

Comorbity of eating disorders and depression in T1DM patients: challenges and tasks for dietetician - a pilot study

A review of risk factors associated with insulin omission for weight loss in type 1 diabetes

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