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Factors Associated With Intentional Insulin Omission to Lose Weight in People Living With Type 1 Diabetes: A BETTER
Courtney A South1, Anne-Sophie Brazeau1, Meryem K Talbo1
1School of Human Nutrition, McGill University, Montréal, Québec, Canada.
Objectives:
Intentional insulin omission to lose weight (IIOLW) occurs when partial or no insulin is administered, reducing glucose uptake in the cells. IIOLW can lead to medical complications, yet factors related to this behaviour are not fully known. In this study we aimed to describe diabetes-related outcomes, mental health, and lifestyle factors of those who reported ever using IIOLW and those who did not, and to determine factors associated with this behaviour.
Methods:
This cross-sectional study included people living with type 1 diabetes (PwT1D) who were ≥18 years of age from a Canadian registry called the Behaviours, Therapies, Technologies, and Hypoglycemic Risk in Type 1 Diabetes (BETTER). Data of those who responded to the question, "Have you ever intentionally omitted insulin to lose weight?" were extracted. Multivariable logistic regression determined factors associated with IIOLW.
Results:
Of the 1,150 PwT1D included, 7.3% (n=84) reported IIOLW. PwT1D who identified as woman (odds ratio [OR] 5.73, 95% confidence interval [CI] 2.65 to 14.98), reported elevated diabetes distress (OR 1.62, 95% CI 1.32 to 2.00), and had more weight cycling occurrences (OR 1.08, 95% CI 1.02 to 1.13) had higher odds of IIOLW. Having an older age of diagnosis (OR 0.98, 95% CI 0.96 to 0.99) lowered the odds of IIOLW. There was insufficient evidence of a relationship between body mass index and IIOLW (OR 1.04, 95% CI 0.99 to 1.08).
Conclusions:
The adverse health outcomes (i.e. weight cycling occurrences, diabetes distress) associated with IIOLW emphasizes the need for improved screening and support for PwT1D who report IIOLW.
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