The role of diabetes distress in Diabulimia.

IMPORTANCE: Diabulimia is a disordered eating behavior in which a person with type 1 diabetes withholds insulin injections to lose weight. It is thought that the psychosocial stress of managing this chronic disease, which is termed diabetes distress, may contribute to developing diabulimia. OBJECTIVE: This paper explores links between diabetes distress and diabulimia and their relevance to the diagnosis and treatment of diabulimia by assessing whether people with diabulimia report measurable evidence of diabetes distress. EVIDENCE REVIEW: We evaluated studies examining the qualitative experiences of people with disordered eating behaviors in the setting of type 1 diabetes for themes of diabetes distress by identifying aspects of the patients' stories that matched the criteria in the Diabetes Distress Scale. Selected studies recorded primary data, analyzed qualitative data, examined lived experiences of individuals with diabulimia, and were made available in English-language peer-reviewed journals between January 1, 2000 and August 31, 2022. Exclusion criteria included partial articles, editorials, reviews, and abstracts along with studies of patients with type 2 diabetes. FINDINGS: Over forty individual participants across twelve studies were found to have aspects of their experiences that met one or more criteria from the Diabetes Distress Scale. Participants reported experiences that matched criteria items from each of the seven subscales of the Diabetes Distress Scale. Participants in the twelve studies included 185 individuals with type 1 diabetes experiencing diabulimia, including 164 females (88.6%), 20 males (10.8%), and 1 non-reported gender (0.54%). CONCLUSION: We believe this discovery warrants further research probing the prevalence of diabetes distress among people with diabulimia as well as other links between the two conditions. We advocate for a diabetes distress-informed approach to diabulimia treatment and for diabetes distress screening in every patient with type 1 diabetes.

The Design, Implementation, and Evaluation of a Health-Themed Residential Learning Community for Undergraduate Students.

College students face significant health concerns. In recent years, there has been an emergence of health-related residential learning communities (RLCs) at institutions of higher education, which endeavor to improve students' academic and health outcomes by offering a communal living environment and programming. However, there is negligible literature describing health-related RLCs as a health promotion intervention, the kind of experience residents have, or the impact that health-related RLCs have on student outcomes. To begin to fill this gap, this article describes a health-themed RLC named HealthWave that was created at a private Southern university and the diverse stakeholders involved. It also summarizes results from a multimethod evaluation that included focus groups, an experience survey, and a quasi-experimental study with non-HealthWave students in the same residence hall as the comparison group. HealthWave was a feasible intervention to implement and residents provided very positive feedback about their experience, although the impact of HealthWave on students' health behavior is unclear. Lessons learned from implementing and evaluating HealthWave are shared in order to inform health promotion professionals' future programmatic and evaluation efforts.