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Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology.

Publication ,  Journal Article
Merwin, RM; Dmitrieva, NO; Honeycutt, LK; Moskovich, AA; Lane, JD; Zucker, NL; Surwit, RS; Feinglos, M; Kuo, J
Published in: Diabetes Care
November 2015

OBJECTIVE: Individuals with type 1 diabetes who restrict insulin to control weight are at high risk for diabetes-related complications and premature death. However, little is known about this behavior or how to effectively intervene. The aim of the current study was to identify predictors of insulin restriction in the natural environment that might inform new treatment directions. RESEARCH DESIGN AND METHODS: Eighty-three adults with type 1 diabetes and a range of eating disorder symptomatology completed 3 days of ecological momentary assessment. Participants reported emotions, eating, and insulin dosing throughout the day using their cellular telephone. Linear mixed models were used to estimate the effects of heightened negative affect (e.g., anxiety) before eating and characteristics of the eating episode (e.g., eating a large amount of food) on the risk of insulin restriction. RESULTS: Individuals who reported greater-than-average negative affect (general negative affect and negative affect specifically about diabetes) during the study period were more likely to restrict insulin. Momentary increases in anxiety/nervousness and guilt/disgust with self before eating (relative to an individual's typical level) further increased the odds of restricting insulin at the upcoming meal. Insulin restriction was more likely when individuals reported that they broke a dietary rule (e.g., "no desserts"). CONCLUSIONS: Results suggest that insulin restriction might be decreased by helping patients with type 1 diabetes respond effectively to heightened negative affect (e.g., anxiety, guilt) and encouraging patients to take a less rigid, punitive approach to diabetes management.

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Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

November 2015

Volume

38

Issue

11

Start / End Page

2025 / 2032

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • Time Factors
  • Surveys and Questionnaires
  • Risk Factors
  • Middle Aged
  • Medication Adherence
  • Male
  • Insulin
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Merwin, R. M., Dmitrieva, N. O., Honeycutt, L. K., Moskovich, A. A., Lane, J. D., Zucker, N. L., … Kuo, J. (2015). Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology. Diabetes Care, 38(11), 2025–2032. https://doi.org/10.2337/dc15-0753
Merwin, Rhonda M., Natalia O. Dmitrieva, Lisa K. Honeycutt, Ashley A. Moskovich, James D. Lane, Nancy L. Zucker, Richard S. Surwit, Mark Feinglos, and Jennifer Kuo. “Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology.Diabetes Care 38, no. 11 (November 2015): 2025–32. https://doi.org/10.2337/dc15-0753.
Merwin RM, Dmitrieva NO, Honeycutt LK, Moskovich AA, Lane JD, Zucker NL, et al. Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology. Diabetes Care. 2015 Nov;38(11):2025–32.
Merwin, Rhonda M., et al. “Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology.Diabetes Care, vol. 38, no. 11, Nov. 2015, pp. 2025–32. Pubmed, doi:10.2337/dc15-0753.
Merwin RM, Dmitrieva NO, Honeycutt LK, Moskovich AA, Lane JD, Zucker NL, Surwit RS, Feinglos M, Kuo J. Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology. Diabetes Care. 2015 Nov;38(11):2025–2032.

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

November 2015

Volume

38

Issue

11

Start / End Page

2025 / 2032

Location

United States

Related Subject Headings

  • Young Adult
  • Weight Loss
  • Time Factors
  • Surveys and Questionnaires
  • Risk Factors
  • Middle Aged
  • Medication Adherence
  • Male
  • Insulin
  • Humans