Eating Disorders and Diabetes: Introduction and Overview

Colton, Patricia; Rodin, Gary; Bergenstal, Richard M.; Parkin, Christopher G.

doi:10.2337/diaspect.22.3.138

Cited by 49 publications

(55 citation statements)

References 51 publications

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“…[1][2][3][4] The effects of a chronic medical condition on body image and selfesteem, the restrictive nature of the diet for controlling T1D and the overweight associated with insulin use are among the mechanisms that have been proposed to explain the association between eating problems and T1D. 5 T1D is a chronic condition characterized by partial or total damage of pancreatic beta cells, resulting in progressive inability to synthesize insulin -the hormone responsible for glucose transport. 6 The objective of treatment is to control glucose levels and ensure the energy supply of cells.…”

Section: Introductionmentioning

confidence: 99%

“…The terms ED-T1D and ED-T2D have been recently proposed to highlight the association of EDs with T1D and type 2 diabetes respectively. 5,9 An association of ED with T1D may be much more hazardous than an ED alone in that it involves a serious lack of metabolic control, higher mortality rates and higher risk of complications, such as diabetic retinopathy. 10,11 Studies on this subject in Brazil have focused on the presence of BED in T2D 12 and have also included reviews 13,14 and case studies.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Insulin omission is an additional purging method employed by insulin-dependent individuals. 5 Insulin restriction causes glucose to build up in the bloodstream instead of being used as the cells' energy supply; it causes hyperglycemia, which leads to excretion of glucose in urine and, consequently, weight loss. This purging method has been cited among the diagnostic criteria for BN in the International Classification of Diseases (ICD-10).…”

Section: Introductionmentioning

confidence: 99%

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Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Philippi

Cardoso

Koritar

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). Conclusions:Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Philippi

Cardoso

Koritar

et al. 2013

Rev. Bras. Psiquiatr.

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“…Although the specificity of this association was initially unclear, systematic research has demonstrated that teenage girls and women with type 1 diabetes are at significantly increased risk of DEB compared with their nondiabetic peers (3). Such DEB includes dieting, fasting, binge-eating, and a range of compensatory and purging behaviors that can directly interfere with optimal diabetes management.…”

mentioning

confidence: 99%

Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence

et al. 2015

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OBJECTIVEGirls and women with type 1 diabetes are at increased risk for developing eating disorders (EDs), and these disorders are associated with serious diabetes-related medical complications. This study describes the longitudinal course of disturbed eating behavior (DEB) and EDs in a cohort with type 1 diabetes. RESEARCH DESIGN AND METHODSA total of 126 girls with type 1 diabetes receiving care for diabetes at The Hospital for Sick Children in Toronto participated in a series of seven interview-based assessments of ED behavior and psychopathology over a 14-year period, beginning in late childhood. Survival analysis was used. RESULTSMean age was 11.8 6 1.5 years at time 1 and 23.7 6 2.1 years at time 7. At time 7, 32.4% (23/71) met the criteria for a current ED, and an additional 8.5% (6/71) had a subthreshold ED. Mean age at ED onset (full syndrome or below the threshold) was 22.6 years (95% CI 21.6-23.5), and the cumulative probability of onset was 60% by age 25 years. The average time between onset of ED and subsequent ED remission was 4.3 years (95% CI 3.1-5.5), and the cumulative probability of remission was 79% by 6 years after onset. The average time between remission of ED and subsequent recurrence was 6.5 years (95% CI 4.4-8.6), and the cumulative probability of recurrence was 53% by 6 years after remission. CONCLUSIONSIn this longitudinal study, EDs were common and persistent, and new onset of ED was documented well into adulthood. Further research regarding prevention and treatment for this vulnerable group is urgently needed.The prevalence, clinical characteristics, and medical consequences of disturbed eating behavior (DEB) and eating disorders (EDs) in individuals with type 1 diabetes has received increasing attention since case reports of this dangerous combination were first published in the 1980s (1,2). Although the specificity of this association was initially unclear, systematic research has demonstrated that teenage girls and women with type 1 diabetes are at significantly increased risk of DEB compared with their nondiabetic peers (3). Such DEB includes dieting, fasting, binge-eating, and a range of compensatory and purging behaviors that can directly interfere with optimal diabetes management. A slide set summarizing this article is available online.

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“…Eating disorders are often associated with underlying disturbances in emotional regulation and body image which leads to poor self-esteem and social isolation. Furthermore eating disorders can result in medical complications such as electrolyte abnormalities, oedema, cardiac conduction abnormalities and gastrointestinal complications (Colton, Rodin, Bergenstal, & Parkin, 2009). Obesity is the biggest complication of binge eating, which in turn may lead to associated health risks and complications, such as cardiovascular disease, gastro-esophageal reflux disease (GERD), sleep related breathing disorders and type II diabetes mellitus (Herrin, 2003).…”

Section: Problem Statementmentioning

confidence: 99%