Final published version
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Research output: Contribution to specialist publication › Article
Research output: Contribution to specialist publication › Article
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TY - GEN
T1 - A Review of Risk Factors Associated with Insulin Omission for Weight Loss in Type 1 Diabetes
AU - Hall, Rebecca
AU - Keeble, Leanna
AU - Sunram-Lea, Sandra-Ilona
AU - To, Michelle
PY - 2021/7/1
Y1 - 2021/7/1
N2 - 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.
AB - 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.
KW - type 1 diabetes
KW - diabulimia
KW - insulin omission
KW - gender
KW - mental health
KW - self-harm
KW - weight concern
KW - eating disorders
KW - anxiety
KW - depression
KW - body dissatisfaction
U2 - 10.1177/13591045211026142
DO - 10.1177/13591045211026142
M3 - Article
VL - 26
SP - 606
EP - 616
JO - Clinical Child Psychology and Psychiatry
JF - Clinical Child Psychology and Psychiatry
SN - 1359-1045
ER -