Diabetes technologies in people with type 1 diabetes mellitus and disordered eating: A systematic review on continuous subcutaneous insulin infusion, continuous glucose monitoring and automated insulin delivery

• Published in: Diabetic medicine Vol. 38; no. 7; pp. e14581 - n/a
• Main Authors: Priesterroth, Lilli, Grammes, Jennifer, Clauter, Mona, Kubiak, Thomas
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.07.2021
• Subjects: anorexia nervosa; automated insulin delivery; Automation; Blood Glucose Self-Monitoring; bulimia nervosa; Case reports; continuous glucose monitoring; continuous subcutaneous insulin infusion; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; disordered eating behaviours; Eating behavior; Eating disorders; Feeding and Eating Disorders - complications; Glucose monitoring; Humans; Hyperglycemia; Insulin; Insulin Infusion Systems; Systematic review; bulimia nervosa; continuous subcutaneous insulin infusion; automated insulin delivery; disordered eating behaviours; eating disorders; anorexia nervosa; continuous glucose monitoring
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.14581

Aims In this systematic review, we aimed (1) to identify and describe research investigating the use of advanced diabetes technologies (continuous subcutaneous insulin infusion, CSII; continuous glucose monitoring, CGM; automated insulin delivery, AID) in people with type 1 diabetes (T1DM) and disordered eating and (2) to discuss potential (dis)advantages of diabetes technology use in this population, derived from previous research. Methods We conducted a systematic literature search in two electronic databases for English articles published between 2000 and 2020 addressing eating disorders and/or dysfunctional eating behaviours and diabetes technology use in children, adolescents and adults with T1DM (PROSPERO ID CRD42020160244). Results Of 70 publications initially identified, 17 were included. Overall, evidence on the use of diabetes technologies in people with T1DM and disordered eating is scarce. The majority of the studies reports findings on CSII in people with T1DM and dysfunctional eating behaviours or eating disorders. Findings predominantly stem from observational data and are, in most cases, secondary findings of the respective studies. Providing the greatest flexibility in diabetes management, CSII may have benefits in disordered eating. CGM data may complement the diagnostic process of disordered eating with a physiological indicator of insulin restriction (i.e. time spent in hyperglycaemia). Conclusions Results on possible (dis)advantages of diabetes technology use in people with T1DM and disordered eating are based on observational data, small pilot trials and anecdotical evidence from case reports. Prospective data from larger samples are needed to reliably determine potential effects of diabetes technology on disordered eating in T1DM.