Department of Psychological Medicine, Weston Education Centre, King's College London, London, UK.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Diabet Med. 2018 Oct;35(10):1329-1336. doi: 10.1111/dme.13700. Epub 2018 Jun 20.
To perform a qualitative review of online blogs authored by people self-identifying as having Type 1 diabetes and an eating disorder or 'diabulimia', a term used by people with Type 1 diabetes to describe an eating disorder that is characterized by deliberate restriction of insulin to control weight.
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-phase process and was conducted by two independent researchers.
From 147 000 search results, 11 blogs (304 posts) matched criteria for further analyses. Three key themes and 18 subthemes emerged: 1) different aspects of bloggers' relationship with insulin, including motives for omitting insulin, secrecy of insulin omission and perception of control; 2) bloggers' experiences of diabetes complications, and diabetes ketoacidosis in particular, 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.
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 for 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.
对自我认同患有 1 型糖尿病和饮食障碍或“diabulimia”（1 型糖尿病患者用来描述以故意限制胰岛素来控制体重为特征的饮食障碍的术语）的人撰写的在线博客进行定性审查。
我们对 2012 年至 2017 年间发表的、自我报告患有 1 型糖尿病和饮食障碍或 diabulimia 的人的在线博客进行了结构化的定性审查。随后的主题分析遵循六阶段过程，由两名独立研究人员进行。
从 147000 个搜索结果中，有 11 个博客（304 篇文章）符合进一步分析的标准。出现了三个关键主题和 18 个子主题：1）博主与胰岛素关系的不同方面，包括省略胰岛素的动机、省略胰岛素的秘密性以及对控制的感知；2）博主的糖尿病并发症，特别是糖尿病酮症酸中毒的经历，以及他们对未来并发症的担忧；3）恢复策略和复发的触发因素，包括糖尿病自我管理和建立支持系统。
对患有 1 型糖尿病和饮食障碍或 diabulimia 的人撰写的博客进行的定性分析发现，糖尿病困扰程度很高，并深入了解了省略胰岛素的不同动机和恢复策略。考虑到针对有效干预措施的证据有限，这些发现可能有助于开发复杂干预措施，以改善该人群的生物医学和心理结果。
