Diabulimia: A Risky Trend Among Adults with Type 1 Diabetes Mellitus

Area of Science:

• Endocrinology
• Psychiatry
• Public Health

Background:

• Poor adherence to diabetes management in type 1 diabetes mellitus (T1DM) is associated with adverse health outcomes.
• Diabulimia, the intentional misuse of insulin for weight management, poses a significant risk to individuals with T1DM.

Purpose of the Study:

• To determine the prevalence of diabulimia among adult T1DM patients.
• To compare the characteristics of patients with and without diabulimia.
• To identify risk factors associated with diabulimia in T1DM patients.

Main Methods:

• A web-based survey was distributed across 21 T1DM online communities.
• The survey collected data on demographics, diabetes management, and psychiatric diagnoses.
• Diabulimia was screened for based on self-reported intentional insulin skipping or underuse for weight control within the past 12 months.

Main Results:

• The prevalence of diabulimia was 8.9% among 225 survey completers.
• Patients with diabulimia had significantly higher hemoglobin A1C (8.4% vs. 6.9%) and increased rates of diabetes-related emergency visits (30.0% vs. 13.2%).
• A diagnosis of major depressive disorder was more common in patients with diabulimia (40.0% vs. 11.5%).

Conclusions:

• Nearly 1 in 11 adult T1DM patients screened positive for diabulimia.
• Elevated A1C levels and a diagnosis of major depressive disorder are significant risk factors for diabulimia.
• These findings highlight the need for integrated mental health and diabetes care for T1DM patients.