Subtypes of Insulin Restriction in Diabetes Management: A Systematic Review

Insulin restriction is commonly studied as a form of disordered eating, but people may restrict insulin for many reasons. This systematic review examined how insulin restriction has been conceptualized and measured, and its associated predictors and outcomes.

Forty-seven unique articles measured non-specified insulin restriction (IR), insulin restriction specifically for weight control (IRWC), or both. Eight studies used non-specified measures to examine insulin restriction for a specific purpose. IR was more prevalent than IRWC, but both occurred equally among men and women across ages. Higher negative emotions were associated with both constructs, while lower self-management behaviors were examined and associated only with IR; both constructs were associated with higher HbA1c. When measured simultaneously, IR and IRWC were not correlated. There may be subtypes of insulin restriction. Future research should develop measures to assess and examine distinct subtypes, and translate findings into effective interventions for this dangerous behavior.