Why is it important to ask about weight, in a patient with type 1 diabetes, and elevated hemoglobin A1c?

The disorder of omission of insulin for weight control is called diabulimia. Patients will sometimes withhold insulin in an effort to lose weight. In this case, Ms. B. said she was fearful of lows, and feared taking more insulin because she had gone down to a blood glucose level of 34 mg/dL on two separate occasions around the time of her diagnosis with diabetes.

She said that she purposefully was running her blood glucoses elevated, but acknowledged that her values were too elevated currently.

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