Title:A Review on Diabulimia: Exploring the Intersection of Disordered Eating, Eating Disorders, Insulin Dose Manipulation, and Type 1 Diabetes
Volume: 22
Issue: 5
Author(s): Velimir Altabas*, Jelena Marinković Radosevic and Nika Grubijesic
Affiliation:
- Department of Endocrinology, Diabetes and Metabolic Diseases, Sestre Milosrdnice University Hospital Center, Zagreb,
Croatia
- School of Medicine, Zagreb, Croatia
Keywords:
Diabulimia, type 1 diabetes, blood glucose monitoring, eating disorders, pancreatic β-cells, gestational diabetes mellitus (GDM).
Abstract:
Introduction: Although insulin is essential for managing type 1 diabetes and is life-saving
for patients with this condition, some individuals may intentionally reduce or omit insulin due
to a fear of weight gain or a desire to lose weight. This behavior is commonly referred to as diabulimia.
Methods: Since diabulimia is not formally defined, a systematic review of the limited literature
was conducted on November 8th, 2024, using PubMed, Scopus, and Web of Science databases.
The search terms included “diabulimia”, “insulin omission”, “insulin restriction”, “eating disorders”,
“disordered eating”, and “type 1 diabetes”. Out of 288 manuscripts, 19 were selected after excluding
non-English articles and screening the titles and abstracts.
Results and Discussion: Eating disorders and disordered eating are common in patients with type
1 diabetes, often driven by concerns regarding body image and weight. These behaviors can complicate
diabetes management, worsen glucose control, and increase the risk of complications. Diabulimia
may develop as a coping mechanism, especially in adolescents with higher body mass index
and a history of eating disorders. Diagnosis is challenging due to the lack of established guidelines,
but poor glucose control can raise suspicion and prompt further psychological evaluation. A
multidisciplinary approach, combining medical care, nutrition, mental health support, and therapy,
is recommended, despite limited evidence.
Conclusion: While diabulimia is not formally recognized, understanding its impact can help
healthcare professionals diagnose and manage it more effectively, improving patients’ health and
well-being.
