Caring for individuals with Type 1 Diabetes Mellitus who restrict and omit insulin for weight control: Evidence-based guidance for healthcare professionals

Purpose: Evidence-based guidance is needed to inform care for individuals with Type 1 Diabetes Mellitus who deliberately restrict and omit insulin for weight control. Consensus on the best treatment approach for these individuals is currently lacking, and standard eating disorder treatment protocols are ineffective. This article focuses on how healthcare professionals can provide meaningful care to this population. Methods: Qualitative research studies were synthesised in a meta-aggregative meta-synthesis. We identified key themes related to individuals' understanding and experience, physical and psychological impacts, support and treatment-related needs and experiences. These themes guided the development of implications for practice. Results: Individuals engaging in insulin misuse wanted healthcare professionals to demonstrate more empathy, validate their experiences, have increased knowledge about their illness and develop more specialist pathways. Conclusions: The findings have widespread interdisciplinary implications for health professionals working with individuals with Type 1 Diabetes Mellitus. Evidence-informed implications for practice are provided and may provide useful guidance concerning the prevention and treatment of this unique behaviour.