This is an 11-year follow-up study of women with type 1 diabetes. A total of 234 women (60% of the original cohort) participated in the follow-up. Mean age was 45 years and mean diabetes duration was 28 years at follow-up. Mean BMI was 25 kg/m(2) and mean A1C was 7.9%. Measures of diabetes self-care behaviors, diabetes-specific distress, fear of hypoglycemia, psychological distress, and eating disorder symptoms were administered at baseline. At follow-up, mortality data were collected through state and national databases. Follow-up data regarding diabetes complications were gathered by self-report. http://ift.tt/2ih5e91

OBJECTIVE:
To determine whether insulin restriction increases morbidity and mortality in women with type 1 diabetes.

It is interesting studies. Let take a look, what they did studied, how they did it, and what they found. Upon reading the info available for me, I did not find answer to my first question, insulin restriction, what is it? It is first question which crossed my mind, what they were looking for in study? If it is not possible to see what is the subject of studies then how it is possible to see the outcome of studies reliable of not?
Beside the fact that 'type 1 diabetes ' has no meaning without the dose of insulin taken by subjects of the study then how we can see what are restrictions in insulin dose, if any?
Conclusion of study:

Our data demonstrate that insulin restriction is associated with increased rates of diabetes complications and increased mortality risk. Mortality associated with insulin restriction appeared to occur in the context of eating disorder symptoms, rather than other psychological distress. We propose a screening question appropriate for routine diabetes care to improve detection of this problem.

      Dose of insulin injected by diabetics of any type usually based on the level of glucose which we see on our home meter. The number on the glucose meter all the time different, never the same. Even anyone try to eat all the time the same meal at the same time, the number on the meter will not be he same. Our insulin secretion depend if there is rain or sunshine, it is Fall or Spring time, diabetic considerably well and healthy or it is another health problem accompany diabetes, ether type of it.
      This number on the glucose meter effect insulin injection dose we take, diabetic of nether type. So, insulin dose in constant change, the same as it is sugar level in blood. Now, I try to find out, insulin restriction, what is it? There is no answer.
If there is no answer to the first question, then how it is possible to see any creditability of the medical studies?
       The studies studies what?
Measures of diabetes self-care behaviors,
diabetes-specific distress,
fear of hypoglycemia,
psychological distress,
and eating disorder symptoms were administered at baseline.
       Still, there is no any mention what dose of insulin was taken, and how there were able to see, what insulin restriction it was?
Let us be clear about ' diabetes self-care behaviors'. It is not the problem what and how much one eat. It is fight every day, what dose of insulin inject into own belly. There is no one education how to connect dose of insulin with level of sugar on glucose meter. The dose of insulin, very complicated math, based on the weight of diabetic. Still, regardless what weight today in the morning and next day in the morning, usually it is about the same, the number on the meter are different. If dose of injected insulin is too high, higher then it is in demand, and no one idea how this demand to find, blood sugar drop low, can drop fatally low. It work in the same way for any diabetic of any type, regardless own diabetic or not. Injected insulin drop blood sugar level in every human being.
       Now, second point, fear of low blood sugar.
       Low blood sugar many medical publishers present as something what is uncomfortable but not really danger. I wish they try to study it in reality. Just inject insulin and see what do you feel and how it can be danger or not. Most important in all those medical publications they no one educate diabetics what to do if sugar is low, how to deal with it. It is wide spread to take sugar and then check up blood sugar level. If the portion of sugar taken did not lead to blood sugar rising, take another portion, and another, and another.... . Because of in reality sugar, or soft drinks do not rise blood sugar. Diabetic can lost consciousness and cannot get off the condition without outside help. Diabetic step too close to the line 'no turn'. Every one of us who stand close to this line afraid low blood sugar. Then more low blood sugar episodes then higher fear of them. Every one of us restrict insulin dose. Even it lead to the blood sugar skyrocket, we do prefer to have high blood sugar then get into low blood sugar drop.
       eating disorder, what they do talking about?
       From this studies eating disorder was in type 1 diabetics who are underweight. In every other publications it is presented that type 2 diabetics have eating disorder because of we are overweight. So, only perfect BMI still without blame for eating disorder? Or regardless of what do we eat, we all do have eating disorder because of we are diabetics? According to the studies it is our eating disorder which leads us to high mortality, right? If so, then what is the reason to blame diabetic type 1 in restriction of insulin? Regardless of any reason or without any reason, the same as diabetics type 2 they still be blamed in own early mortality.

        Great studies, I would say. Finally, they said it. weight has no reason to blame. Regardless what weight we do have, what type of diabetes we do have, it is insulin dose, it is restriction of insulin dose or limit of insulin secretion which lead diabetic to high mortality. Now there must be next step, ho to determine dose of insulin to inject according to the level of sugar on glucose meter. Would be someone so brave to do the job?

Great job Goebel-Fabbri AE¹, Fikkan J, Franko DL, Pearson K, Anderson BJ, Weinger K.!
http://ift.tt/2ih5e91

2008 Mar;31(3):415-9. Epub 2007 Dec 10.