Long-Term Insulin Pump Treatment in Girls with Type 1 Diabetes and Eating Disorders—Is It Feasible?

Abstract

Treatment with an insulin pump was feasible in girls with T1DM and ED and resulted in significantly lower HbA1c levels compared to the ED-MDI group.

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

“…7 Another study of teenage females with T1D and preexisting eating disorders demonstrated that those treated by pump had better glycemic control than those on multiple daily injections. 8 The transition to insulin pump therapy may have an impact on eating behaviors, providing an opportunity either to normalize behaviors or to intensify a focus on eating behaviors. Additional prospective research in this area is needed as no studies to date have examined the relationship among disordered eating, initiation of pump therapy, and glycemic control, particularly using a diabetes-specific measure of disordered eating behaviors.…”

Diabetes technologies in people with type 1 diabetes mellitus and disordered eating: A systematic review on continuous subcutaneous insulin infusion, continuous glucose monitoring and automated insulin delivery

“…Of the 17 included studies, 15 studies addressed the use of CSII in people with T1DM and disordered eating. 11,12,[34][35][36][37][38][39][40][41][42][43][44][45][46] Three studies referred to CGM (two of which also addressed CSII), 38,39,47 and one study referred to the use of AID in people with T1DM and disordered eating 48 (Table 1). Fourteen studies, thirteen with observational and one with controlled design, were eligible for quality assessment.…”

“…11,12,34,35,37,42,44,47 Of the six remaining studies, three indicated a low 38,39,46 and three indicated a high risk of bias. 36,43,45 Notably, the quality assessment captures the studies' quality in terms of their main aims and hypotheses, which were, in some cases, not the findings we extracted for this review (Table 1).…”

“…To test the general feasibility of CSII treatment in female adolescents with T1DM and dysfunctional eating behaviours, Pinhas-Hamiel and colleagues conducted a retrospective pilot study with N = 63 girls, of whom n = 15 showed intentional insulin omissions, restrictive eating behaviour or binge-eating behaviour. 43 Of these 15 adolescents, n = 8 used CSII and had significantly lower HbA1c levels compared with the n = 7 adolescents on MDI. Despite limitations such as the prohibitively small sample size, Pinhas-Hamiel et al concluded that CSII is feasible in adolescents with T1DM and disordered eating behaviours.…”

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

“…Insulin regimes may be revised accordingly with some evidence that pump therapy (with lower insulin requirements which minimises weight gain) leads to reduced disordered eating behaviours16 and better HbA1c in those with T1DM and eating disorders 17…”