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Eat Disord. 2018 Jul-Aug;26(4):343-360. doi: 10.1080/10640266.2017.1405651. Epub 2017 Nov 28.

Disordered eating and insulin restriction in type 1 diabetes: A systematic review and testable model.

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a Melbourne School of Psychological Sciences , The University of Melbourne , Melbourne , VIC , Australia.
b Nutrition and Behaviour Unit, School of Experimental Psychology , University of Bristol , Bristol , United Kingdom.



To provide an overview of the existing literature pertaining to insulin restriction as a disordered eating behaviour in individuals with type 1 diabetes and present a novel maintenance model: The Transdiagnostic Model of Disordered Eating in Type 1 Diabetes.


A systematic review was conducted of the current literature relevant to insulin restriction and/or omission in the context of disordered eating in type 1 diabetes. A new maintenance model was then developed by incorporating diabetes-specific factors into existing eating disorder models.


Type 1 diabetes may complicate the development and maintenance of disordered eating behaviour. Diabetes-specific circumstances, including disease diagnosis, insulin management, insulin restriction, and diabetes-related complications, contribute to the maintenance of disordered eating cognitions and behaviours.


The proposed model offers a comprehensive representation of insulin restriction as a disordered eating behaviour in type 1 diabetes. Future research should test the model to further understand the mechanisms underlying disordered eating in type 1 diabetes and inform treatments for this at-risk population.

[Indexed for MEDLINE]

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