Eating disorders common in people with insulin-dependent diabetes, finds study

Eating disorders are more prevalent in people with diabetes than in the general population and they are also more deadly. Many diabetes-related factors increase the risk of eating disorders, such as concerns over shape and weight, a focus on diet and carbohydrates, and difficulties coping with long-term conditions. Certain risk factors, such as high body mass index (BMI), body dissatisfaction, deficient coping strategies, and symptoms of depression, are associated with eating disorders of both type 1 and type 2 diabetes.

Patients with insulin-dependent diabetes have a unique form of disordered eating known as insulin omission. Insulin omission refers to intentionally skipping insulin doses to lose glucose calories through the glucose excretion in the urine, leading to weight loss

“Intentional skipping or restriction of insulin doses will lead to weight loss, but this also maintains high blood glucose, throwing diabetes management off balance,” said Doctoral Researcher Pia Niemelä of the University of Eastern Finland.

Researchers conducted a meta-analysis by compiling findings from 45 previous studies. The data included a total of 11,592 individuals with insulin-dependent diabetes, of whom 2,521 exhibited eating disorder symptoms.

The result revealed that eating disorder symptoms were more common in women than in men, which is an observation that has previously been made in young people as well. Age, however, was not a significant factor, as eating disorders occurred regardless of age group.

“Eating disorder symptoms are often thought to affect adolescents and young adults. However, our meta-analysis shows that adults, too, suffer from eating disorder symptoms, which is why it is important to learn to identify patients with eating disorders. Understanding the clinical picture and its prevalence is the first step in developing treatment and care pathways,” said Niemelä.

Reference: Pia E. Niemelä, Hanna A. Leppänen, Ari Voutilainen, Essi M. Möykkynen, Kirsi A. Virtanen, Anu A. Ruusunen, Reeta M. Rintamäki; Prevalence of eating disorder symptoms in people with insulin-dependent-diabetes: A systematic review and meta-analysis; Eating Behaviors; Volume 53 2024; https://doi.org/10.1016/j.eatbeh.2024.101863.