Prevalence of Diabulimia in Adults with Type 1 Diabetes Mellitus

Título

Introdução

It is estimated that approximately 9.4 million people worldwide live with Type 1 Diabetes Mellitus (T1DM), including 600,000 in Brazil. One of the main challenges in managing this condition is diabulimia, characterized by the deliberate omission of insulin for weight control, which is more common among women (37.9%) but also affects adult men (15.96%) with T1DM. Diabulimia is associated with weight variation, strict carbohydrate control, elevated glycated hemoglobin (HbA1c) levels, and dietary restriction. Therefore, early screening for diabulimia should be incorporated into clinical practice using tools specifically designed for this population.

Objetivo

To estimate the prevalence of diabulimia among adults with Type 1 Diabetes Mellitus.

Método

This was a cross-sectional study conducted at a specialized center in Fortaleza, Ceará, Brazil. Eligible participants were adults (≥18 years) diagnosed with T1DM for at least 12 months and receiving quarterly clinical follow-up in accordance with ADA guidelines. Pregnant women were excluded. The target population comprised 1,907 adults with T1DM followed at the center. Prevalence was calculated based on the number of cases identified by the DEPS-R questionnaire, divided by the total number of adults with T1DM and multiplied by 100,000. Sociodemographic data were also collected. The study was approved by the Research Ethics Committee of the State University of Ceará (approval no. 7.091.417).

Resultados

Of the 73 participants, 34 (46.5%) scored 20 or higher on the DEPS-R, indicating the presence of diabulimia. The estimated prevalence of the condition among the adult T1DM population at the center was 1.78 cases per 100,000 individuals. Among the participants, there was a predominance of males (n = 46; 63%) and individuals self-identified as mixed race (n = 36; 49.3%), with a mean age of 26 years.

Conclusão

The study identified a notably high proportion of potential diabulimia cases among adults with T1DM, suggesting a significant presence of the condition in this population. The findings emphasize the importance of early screening in clinical settings and reinforce the need for specific assessment tools and trained multidisciplinary teams to manage eating disorders in individuals with T1DM.

Palavras Chave

Diabulimia; Type 1 Diabetes Mellitus; Cross-Sectional Study