Volume 30, Issue 167, January 2026

Diabulimia: characteristics, psychopathology, and treatment approaches - a narrative review

Natalia Kriese^♦, Ewelina Komorowska, Jakub Szyszkowski, Tomasz Kucharski, Brygida Tucka, Zuzanna Zgrzywa, Izabella Zawadzka, Paulina Wądołowska, Jakub Jaworski, Bartłomiej Kowalski

Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Natalia Kriese, Medical University of Warsaw, Żwirki i Wigury 61, 02- 091 Warsaw, Poland

ABSTRACT

Background: Diabulimia, the intentional omission or reduction of insulin administration in a patient with type 1 diabetes mellitus (T1DM) to lose weight, is now becoming an increasingly recognized problem in both diabetology and psychiatry. Aim: In this review, we will consolidate and analyze the available research on diabulimia and its clinical implications, including screening methods, potential complications, and treatment. Materials and Methods: After a thorough search of medical databases (Scopus, PubMed/MEDLINE), we analysed publications published from January 2000 to September 2025 and selected 23 articles based on their quality and significance. This narrative review includes original research, meta-analyses, and reviews on diabulimia and other eating disorders linked to T1DM. Results and discussion: Patients with diabulimia are at higher risk of developing both short-term complications of diabetes (ketoacidosis) and long-term complications (retinopathy, neuropathy, microvascular complications). Therefore, a screening should be performed to early diagnose it and to implement treatment. Because the disorder itself is complex and multidisciplinary, its management must likewise address both the somatic and psychiatric components. Alongside re-nourishing and stabilising the life signs, family counselling and cognitivebehavioral therapy should be implemented. Conclusions: Diabulimia is a life-threatening disorder that needs to be addressed by a multidisciplinary team, including an endocrinologist, psychologist, and social workers. Further research is required to evaluate the long-term benefits of treatment and to establish clear clinical guidelines for the management of patients with diabulimia.

Keywords: Diabulimia, diabetes mellitus, eating disorders, insulin omission

Medical Science, 2026, 30, e19ms3770

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DOI: https://doi.org/10.54905/disssi.v30i167.e19ms3770

Published: 30 January 2026