Diabulima Through the Lens of Social Media: A Qualitative Review and Analysis of Online Blogs of People with Type 1 Diabetes Mellitus and Eating Disorders

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Abstract

AIMS
Diabulimia is a term used by people with type 1 diabetes to describe their eating disorder that is characterised by deliberate restriction of insulin to control weight. Diabulimia is associated with high morbidity and mortality, but very little is known about the experience of living with diabulimia, because these people are vulnerable and hard to reach.
METHODS
We conducted a structured qualitative review of online blogs published between 2012 and 2017 authored by people who report having type 1 diabetes and an eating disorder or diabulimia. The subsequent thematic analysis followed a six-phased process and was conducted by two independent researchers.
RESULTS
From 147,000 search results, 11 blogs (304 posts) matched criteria for further analyses. Three key themes and 18 subthemes emerged:
1) Bloggers described different aspects of their relationship with insulin, including motives for omitting insulin, secrecy of insulin omission and perception of control;
2) Bloggers’ experiences of diabetes complications, diabetes
ketoacidosis in particular, were described, as well as their worries about future complications;
3) Strategies for recovery and triggers for relapse, which involved diabetes self-management and setting up a support system.
CONCLUSIONS
Qualitative analyses of blogs authored by people with type 1 diabetes and an eating disorder or diabulimia have identified high levels of diabetes distress and provided insight into different motives of insulin omission and strategies for recovery. Considering the limited evidence for effective interventions, these findings may help the development of complex interventions to improve biomedical and psychological outcomes in this group.
Original languageEnglish
Pages (from-to)1329-1336
JournalDiabetic Medicine
Volume35
Issue number10
Early online date1 Jun 2018
DOIs
Publication statusPublished - Oct 2018

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