Analysis of YouTube Brazilian videos as a source of information about diabulimia (Preprint)

BACKGROUND YouTube consist of a video publishing tool available in cyberspace with unrestricted, decentralized and interactive access. The YouTube plataform offers thousands of videos to acquire knowledge and virtual interaction between people. It is known that sharing videos is a resource that can influence patient behavior. Studies show the importance of YouTube as a source of useful information about some diseases, including Diabetes Mellitus (DM). However, no study has evaluated the use of YouTube as a source of information on diabulimia, a term used to describe the intentional omission of insulin in individuals with DM type 1 as a strategy for weight loss. OBJECTIVE In this study, our aim was to research the source and audience of videos on YouTube Brazil regarding diabulimia. METHODS The YouTube site was searched on March 18, 2017, for two associated keyword terms "Diabulimia and Diabetes". Videos not recorded in Brazilian Portuguese language and those not related to the focus were excluded. Were included the videos associated with the terms and available on YouTube. Video links were recorded and analyzed independently by E.S. and G.K.C.C. Were recorded the following criteria for all videos: upload date, number of views, duration, likes, dislikes, and comments. The source of the videos was categorized into three groups: patients, health professionals and others sources. RESULTS The search resulted in a total of 427 videos, of which 417 (97.66%) were excluded (332 in English, 83 in Spanish, 1 in Danish, and 1 in Portuguese from Portugal). Then, 10 (2.34%) videos were pre-selected and analyzed. This videos were uploaded to YouTube between 2007 and 2016, and showed the following metrics: 10.303 views; 707 likes; 11 dislikes, and 115 comments. The total run time of the videos was 5 minutes and 22 seconds. The source of the videos revealed the following classification: professionals (30%, doctors), patients (20%) and others sources (50%, including advertisement, TV programm, etc.). Only two Brazilian videos related diabulimia with DM. CONCLUSIONS This research showed that YouTube in Brazil is little used, both in the availability of videos and in the search for information that associates diabulimia with DM. This finding admits the YouTube's potential as a tool for use in health education about this theme. There were contributions from health professionals in the process of transmitting videos on YouTube Brazil, but the videos of advertisements and the videos of reports were predominat. This result is worrying because it configures serious risks of transmission with inaccurate or misleading information about DM and diabulimia on the Internet. Thus, we emphasize the need to produce videos about diabulimia for use in diabetes online health education in Brazil.