Insulin Omission

2021 ◽

pp. 135910452110261

Author(s):

Rebecca Hall ◽

Leanna Keeble ◽

Sandra-Ilona Sünram-Lea ◽

Michelle To

Keyword(s):

Risk Factors ◽

Weight Loss ◽

Type 1 Diabetes ◽

Body Dissatisfaction ◽

Vascular Complications ◽

Anxiety And Depression ◽

Weight Concerns ◽

Complications And Mortality ◽

Insulin Omission

Research suggests that as many as 60% of people with type 1 diabetes (T1D) admit to misusing insulin. Insulin omission (IO) for the purpose of weight loss, often referred to as diabulimia, is a behaviour becoming increasingly recognised, not least since prolonged engagement can lead to serious vascular complications and mortality. Several risk factors appear to be relevant to the development of IO, most notably gender, anxiety and depression and increased weight concerns and body dissatisfaction. Evidence suggests that women, especially young girls, are more likely to omit insulin as a method of weight loss compared to men. Mental health conditions such as anxiety and depression are increasingly prevalent in people with T1D compared to their peers, and appear to contribute to the risk of IO. Increased weight concerns and body dissatisfaction are further prominent risk factors, especially given increases in weight which often occur following diagnosis and the monitoring of weight by diabetes teams. This review presents evidence examining these risk factors which increase the likelihood of a person with T1D engaging in IO and highlights the complications associated with prolongment of the behaviour. Further research looking at the comorbidities of these risk factors, alongside other factors, would provide greater insight into understanding IO in people with T1D.

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Insulin Adherence in Type 2 Diabetes in Mexico: Behaviors and Barriers

Journal of Diabetes Research ◽

10.1155/2018/3190849 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Janneth Bermeo-Cabrera ◽

Paloma Almeda-Valdes ◽

Josefa Riofrios-Palacios ◽

Carlos A. Aguilar-Salinas ◽

Roopa Mehta

Keyword(s):

Type 2 Diabetes ◽

Insulin Therapy ◽

Low Socioeconomic Status ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Factors Associated ◽

Fear Of Hypoglycemia ◽

Insulin Omission

Objective. To investigate factors associated with insulin adherence in subjects with type 2 diabetes mellitus (T2D) attending a tertiary care centre in Mexico City. Material and Methods. Cross-sectional study, including 200 patients. Adherence to insulin therapy was measured with a medication adherence questionnaire. Sociodemographic data and factors related to insulin omission were collected and compared between the nonadherent and adherent groups. Results. We categorized 117 (58.5%) patients as nonadherent and 83 (41.5%) as adherent. Among the adherent, only 22 patients (11%) had excellent adherence to insulin therapy. The following factors were associated with nonadherence: lack of planning of daily activities (46.1%), fear of hypoglycemia (41%), economic factors (15.4%), and number of insulin applications (2.31 versus 1.76 applications per day). Conclusions. In this study, patients with type 2 diabetes attending a tertiary care referral centre showed inadequate adherence to insulin therapy. The principal factors associated with insulin omission were low socioeconomic status, fear of hypoglycemia, and a greater number of insulin applications per day.

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Insulin Omission in Women With IDDM

Diabetes Care ◽

10.2337/diacare.17.10.1178 ◽

1994 ◽

Vol 17 (10) ◽

pp. 1178-1185 ◽

Cited By ~ 194

Author(s):

W. H. Polonsky ◽

B. J. Anderson ◽

P. A. Lohrer ◽

J. E. Aponte ◽

A. M. Jacobson ◽

...

Keyword(s):

Insulin Omission

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Psychological problems

10.1093/med/9780198766452.003.0011 ◽

2016 ◽

Author(s):

David Levy

Keyword(s):

Depressive Disorders ◽

Poor Glycaemic Control ◽

Single Parenthood ◽

Background Population ◽

Psychological Disturbances ◽

Type1 Diabetes ◽

Family Based ◽

Insulin Omission ◽

Family Based Interventions

Psychological disturbances occur throughout Type1 diabetes, from diagnosis to the experience of late tissue complications. Serious life events may precipitate diabetes onset. All parents of newly diagnosed children report stress. Poor glycaemic control is associated with suboptimal school performance, but children do not consider their own quality of life to be poor. Depression during adolescence is no more common than in the background population. Single parenthood and minority ethnicity are associated with worse glycaemic outcomes. Poor glycaemia associated with poor family functioning can be helped by family-based interventions. Eating disorders are not more frequent in diabetes, but disordered eating and insulin omission are prevalent, the last associated with increased mortality. Depression is common, often severe, undiagnosed, and associated with maternal depression. Non-pharmacological treatment is more effective than antidepressants. Diabetic complications increase the risk of depression 2- to 3-fold, and all depressive disorders may increase mortality in people with foot ulceration.

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207-OR: Intentional Insulin Omission for Weight Loss and Psychosocial Outcomes among Youth with Type 1 Diabetes: Findings from Routine Screening

Diabetes ◽

10.2337/db19-207-or ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 207-OR

Author(s):

JACLYN L. PAPADAKIS ◽

LINDSAY M. ANDERSON ◽

ANTHONY T. VESCO ◽

MEREDYTH A. EVANS ◽

JILL WEISSBERG-BENCHELL

Keyword(s):

Weight Loss ◽

Type 1 Diabetes ◽

Psychosocial Outcomes ◽

Routine Screening ◽

Insulin Omission

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The duration of severe insulin omission is the factor most closely associated with the microvascular complications of Type 1 diabetic females with clinical eating disorders

International Journal of Eating Disorders ◽

10.1002/eat.20498 ◽

2008 ◽

Vol 41 (3) ◽

pp. 259-264 ◽

Cited By ~ 48

Author(s):

Masato Takii ◽

Yasuko Uchigata ◽

Shoji Tokunaga ◽

Naoko Amemiya ◽

Naoko Kinukawa ◽

...

Keyword(s):

Eating Disorders ◽

Microvascular Complications ◽

Insulin Omission

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Efficacy of a Smart Insulin Pen Cap for the Management of Patients with Uncontrolled Type 2 Diabetes: A Randomized Cross-Over Trial

Journal of Diabetes Science and Technology ◽

10.1177/19322968211033837 ◽

2021 ◽

pp. 193229682110338

Author(s):

Rodolfo J. Galindo ◽

Clementina Ramos ◽

Saumeth Cardona ◽

Priyathama Vellanki ◽

Georgia M. Davis ◽

...

Keyword(s):

Type 2 Diabetes ◽

Patient Satisfaction ◽

Glycemic Control ◽

Treatment Adherence ◽

Treatment Satisfaction ◽

Active Phase ◽

Oral Agents ◽

And Control ◽

Insulin Omission

Background: We studied a smart insulin pen cap that can be plugged to several brand of insulin pens, to track insulin administration via smart-phone Bluetooth technology, with alarm/reminder system aiming. Methods: This pilot randomized, cross-over design study assessed the use of a smart insulin pen cap in improving adherence, glycemic control and patient satisfaction in insulin-treated patients with poorly controlled type 2 diabetes. Eighty patients on basal insulin ± oral agents with hemoglobin A1C (HbA1c) between 7.0% and 12.0% were randomized to a 12-week active phase receiving alarms/reminders and a 12-week control/masked phase without feedback. We assessed differences between groups on treatment adherence, insulin omission, and mistiming of insulin injections, HbA1c, treatment satisfaction (using Diabetes Treatment Satisfaction Questionnaire Status). Results: Compared to the control/masked phase, the active phase resulted in lower mean daily blood glucose (147.0 ± 34 vs 157.6 ± 42 mg/dL, P < .01); and greater reduction in HbA1c from baseline (−0.98% vs −0.72%, P = .006); however, no significant differences in treatment adherence, insulin omission or insulin mistiming were observed. High patient satisfaction scores were reported in both active and control phases, with DTSQc of 15.5 ± 3.7 and 14.9 ± 3.6, respectively. Statistical models showed no residual effect after cross-over between active and control phases. Conclusions: The results of this pilot study indicates that this smart insulin pen cap was effective in improving glycemic control with overall good satisfaction in insulin treated patients with type 2 diabetes. Future studies are needed to confirm its potential for improving care in insulin treated patients with diabetes.

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