Publication
Insulin restriction or omission in Type 1 Diabetes Mellitus: a meta-synthesis of individuals’ experiences of diabulimia
Publisher:
Informa UK Limited
Date:
31-01-2022
DOI:
10.1080/17437199.2021.2025133
Abstract: Unique to in iduals with insulin-dependent diabetes mellitus is a disordered eating behaviour whereby insulin is deliberately restricted or omitted. Despite growing research in this area, experiential perspectives of in iduals remain understudied. Therefore, this meta-synthesis sought to explore the experiences of in iduals with Type 1 Diabetes Mellitus by identifying, analysing and synthesising existing knowledge concerning this misuse of insulin. Meta-aggregative techniques were employed to generate synthesised findings related to in iduals' understanding and experience, physical and psychological impacts, support and treatment-related needs, noted in twelve studies. A multifaceted relationship with insulin misuse, beyond weight control was identified. Many in iduals experienced diabetes-related complications alongside increased distress, loss of control and feelings of regret, guilt, and shame. Almost all in iduals valued support from those who shared a 'diabulimic' identity peer support appeared more conducive to recovery than support from others including formal support services. This meta-synthesis highlights the need for empathic, collaborative care, and proactive prevention and intervention. The findings highlight the value of peer support, the need for increased knowledge among informal supports, training among multidisciplinary teams and support services, and crucially the development of evidence-based treatments informed by the behaviour as a unique distinct construct.