Fifteen-minute consultation: Diabulimia and disordered eating in childhood diabetes

Candler, Toby; Murphy, Rhian; Pigott, Aisling; Gregory, John W.

doi:10.1136/archdischild-2017-312689

Cited by 25 publications

(42 citation statements)

References 15 publications

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“…Candler et al discuss why this might be. 12 Young newly diagnosed people with diabetes are vulnerable. They are subjected to regular weight checks, carbohydrate counting and painful injections.…”

Section: Discussionmentioning

confidence: 99%

Diabulimia: an easily missed diagnosis?

Heyningen

Manoharan

2018

Br J Diabetes

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Section: Discussionmentioning

confidence: 99%

Diabulimia: an easily missed diagnosis?

Heyningen

Manoharan

2018

Br J Diabetes

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“…Eilander et al (2017) suggested the screening of 'yellow flags' including elevated glycated haemoglobin A1c levels, dieting frequency, reduced quality of life, lower diabetes self-confidence, worsened diabetes management, body dissatisfaction and older age. Candler et al (2018) similarly suggested that clinicians pay attention to a number of potential indicators of eating difficulties including changes in eating habits, low mood, poor self-esteem, weight loss or gain, distorted body image, worsened glyaemic control, missed or cancelled appointments, change in school attendance and secretive behaviour, in addition to screening tools.…”

Section: Eating Disorders Screening In Individuals With Type 1 Diabetesmentioning

confidence: 99%

Prevention and early help for eating disorders in young people with type 1 diabetes

Oldham-Cooper

Semple

2021

Clin Child Psychol Psychiatry

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There is building evidence that early intervention is key to improving outcomes in eating disorders, whereas a ‘watch and wait’ approach that has been commonplace among GPs and other healthcare professionals is now strongly discouraged. Eating disorders occur at approximately twice the rate in individuals with type 1 diabetes compared to the general population. In this group, standard eating disorder treatments have poorer outcomes, and eating disorders result in a particularly high burden of morbidity. Therefore, our first priority must be prevention, with early intervention where disordered eating has already developed. Clinicians working in both eating disorders and diabetes specialist services have highlighted the need for multidisciplinary team collaboration and specific training, as well as improved treatments. We review the current evidence and future directions for prevention, identification and early intervention for eating disorders in children and young people with type 1 diabetes.

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“…Prevalence rates of IO vary widely depending on the methodology used, but studies using the Diabetes Eating Problem Survey-Revised (DEPS-R; Markowitz et al, 2010 ), a questionnaire considered one of the most psychometrically robust methods currently available in assessing insulin manipulation, have reported prevalence as high as 60.2% in a sample of individuals with T1D aged 13–55 years ( Deiana et al, 2016 ). Rates of IO among children and adolescents with T1D are currently somewhat unclear, perhaps partly because young people are often reluctant to disclose issues with their diabetes teams ( Candler et al, 2018 ). However, the use of IO as a weight control has been reported in 2% of preadolescent girls ( Colton et al, 2004 ), and 11–15% in adolescent girls ( Jones et al, 2000 ).…”

Section: Introductionmentioning

confidence: 99%

A review of risk factors associated with insulin omission for weight loss in type 1 diabetes

Hall

Keeble

Sünram-Lea

et al. 2021

Clin Child Psychol Psychiatry

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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.

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Fifteen-minute consultation: Diabulimia and disordered eating in childhood diabetes

Abstract: Type 1 Diabetes (T1DM) is a common chronic disease in children and young people. Living

Cited by 25 publications

References 15 publications

Diabulimia: an easily missed diagnosis?

Diabulimia: an easily missed diagnosis?

Prevention and early help for eating disorders in young people with type 1 diabetes

A review of risk factors associated with insulin omission for weight loss in type 1 diabetes

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