New
Service for TodaysSeniorsNetwork.com
readers...roll mouse over, click on
highlighted links in stories to review items
from Amazon
Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Restricting Insulin doses increases
Mortality Risk
Newswise — A new study led by researchers at
the Joslin Diabetes Center has found that
women with type 1 diabetes who reported
taking less insulin than prescribed had a
three-fold increased risk of death and
higher rates of disease complications than
those who did not skip needed insulin shots.
The new research appears in the March issue
of Diabetes Care.
The study highlights the dangers of insulin
restriction and concludes that mortality
associated with the behavior appears to
occur in the context of eating disorder
symptoms often exhibited in women with
diabetes – sometimes referred to as
“diabulimia” in the media.
This 11-year follow-up study of 234 women is
one of the first to show an increased risk
of mortality as well as higher rates of
kidney and foot problems in those who
restricted their insulin intake.
In addition, the average age of death was
younger for those involved in insulin
restriction: 45 years of age as compared to
58 years for those who did not restrict.
Thirty percent of the subjects reported
restricting their insulin intake at the
study’s outset.
Frequency of the behavior appears to
influence mortality risk.
Insulin-restricting women who died had
reported more frequent insulin restriction
and reported more eating disorder symptoms
at the study’s outset than those
insulin-restrictors who were still living at
study’s end.
Eating disorder symptoms include extreme
concern for body weight and shape, judging
self worth according to a thin body ideal,
restrictive eating patterns, binge eating
and other methods of purging calories, such
as vomiting.
“This is an incredibly important women’s
health issue in the area of diabetes,” said
lead author Ann E. Goebel-Fabbri, Ph.D.,
psychologist and investigator in the Section
on Behavioral and Mental Health at Joslin
Diabetes Center and instructor at Harvard
Medical School.
“The average age of death was significantly
younger in the insulin-restricting group,”
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 study’s 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 Psychiatry at Harvard Medical
School.
More information on this topic can be found
on the Joslin web site:
http://www.joslin.org/managing_your_diabetes_4039.asp.
Funding for the study was provided by the
Center for Excellence in Women’s Health at
the Harvard Medical School. The center is
funded by the National Institutes of Health.
Other researchers participating in the study
included: Janna Fikkan, MA, Debra L. Franko,
Ph.D., Kimberly Pearson, M.D., and Barbara
J. Anderson, Ph.D.
About Joslin Diabetes Center
Joslin Diabetes Center is the world’s
largest diabetes clinic, diabetes research
center and provider of diabetes education.
Joslin is dedicated to ensuring people with
diabetes live long, healthy lives and offers
real hope and progress toward diabetes
prevention and a cure for the disease.
Founded in 1898 by Elliott P. Joslin, M.D.,
Joslin is an independent nonprofit
institution affiliated with Harvard Medical
School. For more information on Joslin, call
1-800-JOSLIN-1 or visit
http://www.joslin.org.
...
...
...