Soumya Shraddhya Paul, Amity University Noida
Diabulimia is a new form of an eating disorder that has been growing lately due to Type 1 Diabetic Mellitus, as seen in a Greek adult population. Diabulimia is derived from two words Diabetes Mellitus and bulimia (an eating disorder). Unlike any other eating disorder, in this, diabetic patients intentionally lower the dose of insulin or completely omit the intake without consulting the doctor. Insulin is an anabolic hormone that in Type 1 Diabetic Mellitus (T1DM) increases weight, any excess carbohydrates taken get directly converted to fat. By reducing the amount of insulin these patients go into acidosis which can help weight loss, by excessive urination that results in glucosuria (elimination of glucose). By doing this the body burns fat to resolve the issue of lack of energy, which results in releasing of ketones which are known as ketoacidosis.
Why do so many T1DM people get affected by eating disorders?
The major factor that triggers eating disorders in people suffering from Type 1 Diabetic Mellitus is body image. People who are undergoing T1DM often suffer from drastic weight gain which affects them mentally, they develop anxiety, depression, binge eating disorders, etc. Due to these, build up negative emotions, low self-esteem develops which play major problems in their thought processes as they tend to feel down, negative comments from friends, family, etc., also play a major part in people who are suffering from DM also need to do carbohydrate counting that can again trigger, cutting out carbohydrates or major macronutrients from the diet.
Brief about the study:
There are a lot of screening tools available to check for people suffering from DM, but it was noted that for T1DM only one tool gave the validated results for adolescents and adults known as, the Diabetes Eating Problem Survey-Revised Version (DEPS-R). It follows a scoring system, increasing risk is predicted by a score of >20. It was noted that initially the tool only had one factor and was later on divided into three factors like high blood glucose level, thinness, and eating habits, more factors can also be added, like later on another factor of avoidance was also added in this test.
The major objective of this study was to check the validity of the Greek model of DEPS-R, investigate the reliability and convergence, along with comparing the single factor DEPS-R with multiple factors. Participants who were selected were above the age of 18, 142 patients were approached out of which 103 adults (75.7% women) were selected who were suffering from T1DM after this screening process was started in which DEPS-R was administered for 4 weeks, later on, a questionnaire was done which involved 16 questions and participants were given a scale point from 0=never to 5=always, the higher the grade points the more likeliness of them suffering from the ED. After this samples of blood, urine, etc were collected along with data like weight, height for BMI was also collected through statistical analysis.
Results:
In this study majority of women took part and they all had a median age of 37, with a normal BMI (Mean=23.96), all of the 103 participants were suffering from DM for approximately 18.3 years, they were all being treated by CGM (73.5%) and MDI insulin regimen (69.9%). The glycemic control was seen to be good (Median HbA1c = 6.80%), both men and women showed good glycemic control, hypoglycemia event was also no different, the DEPS-R system gave a reliable result with around 31 people showing a tendency to develop an eating disorder.
Significance of the study:
Early diagnosis of an eating disorder can prevent complications associated with Diabetes mellitus. Tests like DEPS-R can help different countries find and design a tool similar to that of Greece, that will help them to identify who is at the higher risk of developing eating disorders due to Type 1 Diabetic Mellitus. A score of ≥ 20 in Greece was enough to determine eating disorders, but for this tool to reach globally similar studies should be done on a cross-countries level.
Also read: Increased Omega-3 consumption linked to cardio-protection
Reference:
- Karastogiannidou, C., Giannoulaki, P., Samaras, I., Kotzakioulafi, E., Didangelos, T., Bocsan, I. C., & Vassilopoulou, E. (2021). The diabetes eating problem survey-revised (Deps-r) in a greek adult population with Type 1 Diabetic Mellitus: Model comparison supporting a single factor structure. Nutrients, 13(7), 2375. https://doi.org/10.3390/nu13072375
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Author info:
Soumya Shraddhya Paul is an undergrad biotechnology student who worked in building 3D prosthetics in Base Hospital Delhi Cantt and holds a key interest in nutraceuticals and enzymology.
Publications:
- https://bioxone.in/news/worldnews/understanding-b-cell-genomics-to-fight-against-covid-19/
- https://bioxone.in/news/worldnews/the-current-ebola-epidemic-comes-to-an-end/
- https://bioxone.in/news/worldnews/epigenetic-changes-can-cause-permanent-changes-to-offsprings/
- https://bioxone.in/news/worldnews/crispr-act-3-0-a-revolution-in-plant-gene-technology/
Social Media Info: www.linkedin.com/in/soumya-shraddhya-paul-858229203
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