Some women with type 1 diabetes play a dangerous game with cutting back their insulin, say researchers at the Joslin Diabetes Center at Harvard Medical School.
These patients choose to skip insulin doses to try and offset the weight gain that sometimes come from treatment. Unfortunately, inadequate insulin levels for type 1 diabetics cause blood sugar imbalances that over time can lead to significant kidney damage, serious eye, skin and foot problems and other diabetes complications.
The risk for voluntary insulin restriction, or “diabulimia,” in type 1 diabetics is especially high because this group of patients already has more than a 2.5 increase risk for general eating disorders, according to some studies.
Ann. E. Goebel-Fabbri, Ph.D. led the Harvard Medical School 11-year follow up study of 234 female type 1 diabetics to see how insulin restriction affected their overall health and death rate. Nearly one-third of the women enlisted in the study confessed to taking less insulin than they were prescribed. The researchers found that these women showed a three-fold increase risk for death and significant increased rates of diabetic complications than the women who stayed on their prescribed course of insulin medication.
“This is an incredibly important women’s health issue in the area of diabetes,” states Dr. Goebel-Fabbri. “Raising awareness of the impact of insulin restriction among clinicians who treat type 1 diabetes is extremely important so that they can make appropriate assessments and referrals to mental health professionals,” added co-author Katie Weinger, Ed.D., R.N. in a Science Daily article.
Goebel-Fabbri, A., et al., 2007. “Insulin Restriction and Associated Morbidity and Mortality in Women with Type 1 Diabetes,” Diabetes Care; 31: pg 415-419.
Science Daily, Feb. 2008, “Restricting Insulin Doses Increases Mortality Risk in Women with Type 1 Diabetes, Study Suggests”: http://www.sciencedaily.com/releases/2008/02/080227082849.htm
Gardner, A., 2008. “’Diabulimia’ Triples Risk Of Death Among Women With Diabetes,” MedicineNet article: http://www.medicinenet.com/script/main/art.asp?articlekey=87460
Watson, S., February 2008. Insulin Cutback Due to an Eating Disorder?” WebMd article. http://diabetes.webmd.com/news/20080227/insulin-cutback-due-to-eating-disorder?print=true#