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Joslin study finds restricting insulin doses increases mortality risk
Date:2/26/2008

up, said Goebel-Fabbri. This behavior emerged as a significant risk factor for mortality.

Type 1 diabetes is the autoimmune form of the disease, in which the body is no longer able to produce insulin, a hormone which allows the body to utilize and store calories for energy. Current treatment guidelines for type 1 diabetes aim at achieving near normal blood glucose ranges by taking multiple daily doses of insulin. This studys findings strongly suggest that insulin restriction and related eating disorder behaviors may be unique barriers to achieving optimal diabetes management, Goebel-Fabbri said.

Women with this behavior need specialized treatment by someone who understands the connection between eating disorders and diabetes, she said. We know that current type 1 diabetes treatment is especially good at preventing complications and preserving longevity. The biggest frustration is knowing that these women, by virtue of their eating disorders, are unable to utilize that lifesaving set of tools.

Goebel-Fabbri noted that other studies have shown that women with diabetes are nearly 2.5 times more likely to develop an eating disorder than women without diabetes. Warning signs include: unexplained elevations in A1c levels; repeated problems with diabetic ketoacidosis (DKA), which can be fatal; extreme concerns about weight and body shape; change in eating patterns; unusual pattern of intense exercise (sometimes associated with frequent hypoglycemia); and ammenorrhea (skipping monthly menstrual cycles).

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 who are experienced in the treatment of people with diabetes, said study co-author Katie Weinger, Ed.D., R.N., investigator in the Section on Behavioral and Mental Health at Joslin Diabetes Center and assistant professor of Psychi
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Contact: Kira Jastive
kira.jastive@joslin.harvard.edu
617-732-2418
Joslin Diabetes Center
Source:Eurekalert

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