Women with type 1 diabetes who are taking less insulin than what is required to control the disease may inadvertently find that their lifespan is reduced by more than a decade, according to a recent study conducted by the Joslin Diabetes Research Center in Boston.

In an 11-year follow-up study, researchers found that women with type 1 diabetes who restricted their insulin intake had an increased risk of death and higher rates of kidney and foot problems, compared to women who did not restrict their insulin dose. A total of 234 women with type 1 diabetes were included in the study, 71 (30 percent) of whom had been classified as insulin restrictors at the start of the study.

The study further found that the average age of death for those who restrict insulin use was younger at 45 years of age, as compared to 58 years for those who did not restrict. 26 women died during the follow-up period, 10 of whom are insulin restrictors. Researchers also report that insulin restriction increased by more than threefold the relative risk of death after adjusting for other factors.

According to study author Dr. Katie Weinger and colleagues, fear of hypoglycemia (low blood sugar) and weight gain concerns with insulin use may lead patients to restrict necessary insulin doses.

The insulin-restricting women who died during follow-up were reported to have had more frequent insulin restriction and more eating disorder symptoms during the study, compared to those insulin restrictors who were still alive by the end of the study. Other studies have also shown that women with diabetes are 2.5 times more likely to develop eating disorders than women without diabetes.

Study authors suggest that doctors should ask their type 1 diabetic patients if they take less insulin than they should, and refer these high-risk patients to mental health professionals.

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