Insulin as a Tool in Factitious Dysglycemia

Abstract

Factitious dysglycemia is a type of self-inflicted harm that includes deliberate attempts to induce hypo-or hyperglycemia as a sickness to gain empathy. We report the cases of three Iraqi women with different motives to induce factitious dysglycemia. Two of them had used insulin to induce hypoglycemia to have their family affection centered on them again. The third woman with type 1 diabetes mellitus intentionally missed her insulin doses to induce diabetic ketoacidosis and gain familial empathy through recurrent hospital admission, with underlying suicidal ideation. The problems with all women were discovered by a thorough history, physical examination, and with family help. They were referred to have psychiatric management. This is the first case series regarding factitious dysglycemia from Iraq.

Determinants of adherence to insulin and blood glucose monitoring among adolescents and young adults with type 1 diabetes in Qatar: a qualitative study

“…Their motives varied, such as mental disorders like major depression or factitious disorder (FD) and/or suicidal ideation. 31 , 34 , 90 – 92 Induced hypoglycemia was also used to justify eating sweets and carbohydrate-rich meals. 31 Factitious dysglycemia should be considered a possible cause of brittle diabetes and requires specialist consultation.…”

Determinants of adherence to insulin and blood glucose monitoring among adolescents and young adults with type 1 diabetes in Qatar: a qualitative study

“…Patients' motives varied, such as mental disorders like major depression or factitious disorder (FD) and/or suicidal ideation. 31,34,[90][91][92] Induced hypoglycemia was also used to justify eating sweets and carbohydrate-rich meals. 31 Factitious dysglycemia should be considered a possible cause of brittle diabetes and requires specialist consultation.…”

“…31 Factitious dysglycemia should be considered a possible cause of brittle diabetes and requires specialist consultation. 90,92 However, the literature on FDs from the Arab region is limited, 93,94 with only one report on Iraqi women with type 1 and type 2 diabetes. 92 More information is needed from the Arab region to clarify FD's clinical profile and implications for T1D.…”

“…90,92 However, the literature on FDs from the Arab region is limited, 93,94 with only one report on Iraqi women with type 1 and type 2 diabetes. 92 More information is needed from the Arab region to clarify FD's clinical profile and implications for T1D. Our findings support results from earlier studies 95,96 indicating that some AYAs with T1D were not sufficiently aware of the consequences of their illness-specific risk behaviors, which could have a negative impact on optimal management and outcomes, such as severe hyperglycemia, diabetic ketoacidosis, and long-term diabetes complications.…”

Ehealth intervention to optimize adherence in late adolescents and young adults with type 1 diabetes

“…A codebook was developed using predefined themes from the interview guide; additional codes and sub-codes that emerged during data analysis were added to the initial codebook [91,92]; (3) developing the analytical thematic framework; a coding tree was created to form the working analytical framework; (4) indexing; applying the analytical framework, during which the thematic framework was applied to all transcripts and supplemented with new emerging themes and categories; (5) charting data into the framework matrix, where participants' responses were summarized in a matrix for each health behavior; and (6) mapping and interpretation. To promote the reliability and validity of data during coding and analysis processes, thus rigor, data verification strategies were used [93]. This was achieved by (1) employing inductive and deductive methods,…”