New Study on “Diabulimia” Outcomes
A new study in the March issue of the journal Diabetes Care examines that gets at the outcomes women might experience from “diabulimia,” because looks at what happens when women with Type 1 diabetes take less insulin than they should. The researchers looked at women (following up with a group they first studied in the early 1990s) who said they ever restricted their insulin (from “rarely” to “always” doing so), compared with those who never did so. They also looked at the women’s self-care tasks (such as blood glucose monitoring), their feelings about living with diabetes and fear of hypoglycemia, psychological symptoms, attitudes related to eating disorders, and their A1C values. They then also looked at the complications the women had experienced.
The researchers found the following things:
- Those who restricted their insulin use (as in “diabulimia”) reported worse self-care behavior, higher distress about having diabetes, greater fear of hypoglycemia, and more general psychological and bulimia and other eating disorder symptoms.
- Women who were “insulin restrictors” at the time of the initial study were more likely to have experienced neuropathy and foot problems by the time of follow-up. Self-reported rates of retinopathy, neuropathy, and cardiovascular complications at follow-up did not differ between insulin restrictors and appropriate insulin users.
- Those who restricted their insulin were 3.2 times more likely to have died during the study period than those who didn’t, even after controlling for BMI, age, and A1C.
- When they looked at women who had died during the study period, those who restricted insulin died younger, at 44 vs. 58 years.
The authors do note that some of the participants may have restricted their insulin intake for other reasons aside from weight-related concerns, but their work seems to demonstrate some unappealing outcomes for those practicing this behavior. They also point out that the kind of specialized care needed by these women is often unavailable, something that has been discussed in our previous thread on this topic, and that more research should be done.
Citation: Goebel-Fabbri AE, Fikkan J, Franko DL, Pearson K, Anderson BJ, Weinger K. Insulin Restriction and Associated Morbidity and Mortality in Women with Type 1 Diabetes. Diabetes Care. 2007 Dec 10; 31(3): 415-19.