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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Questionnaires were sent to 550 female patients aged 13 to 45, with insulin-dependent diabetes to determine the prevalence of eating disorders in this population. Seventy percent of the questionnaires were returned and analyzed. One percent of respondents met criteria for lifetime prevalence of anorexia nervosa, 16.2% for lifetime prevalence of bulimia, and 4.9% for induced glycosuria. Contrary to previous studies, the prevalence of bulimia and anorexia was within the range identified in the general population, although at the upper end of the range. The medical risks incurred by women with diabetes who have eating disorders, however, are substantially greater and warrant attention. The incidence of induced glycosuria is a significant problem for diabetes educators and health care providers working with women who have discovered a dangerous but effective way to lose weight.
Diabetes Educ
PMID:The prevalence of anorexia nervosa, bulimia, and induced glycosuria in IDDM females. 279 61

This study analyzed eating attitudes and plasma glucose, insulin, unesterified fatty acid (FFA), human growth hormone (GH), and cortisol responses to an oral (100 g) glucose load in 26 female anorexia nervosa patients at an 8-year outcome evaluation in comparison to 14 age-matched female control subjects. Recovered patients who were of normal body weight and had cyclical menstruation (n = 19) showed glucose tolerance curves and insulin, cortisol, and GH responses that were indistinguishable from those of normal subjects, although patients tended to be more diet-conscious than controls and showed elevated fasting FFA levels. Two of 19 recovered patients met criteria for impaired glucose tolerance. Nonrecovered patients (n = 7) showed abnormal eating attitudes at an average underweight of 20% with persistent amenorrhea or oligomenorrhea. They had high fasting FFA plasma levels, significantly greater than normal rises in plasma glucose, a significant delay in serum insulin secretion, higher mean glucose levels before and after controlling for amount of exercise, and paradoxical release of GH. One of seven patients met criteria for diabetes mellitus and two of seven had impaired glucose tolerance. The findings suggest that fasting plasma FFA levels may reflect patients' eating and exercise habits more accurately than their verbal or written reports.
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PMID:Eating attitudes and glucose tolerance in anorexia nervosa patients at 8-year followup compared to control subjects. 305 85

The change in the levels of free thyroid hormones and the pathophysiology of the hypothalamo-pituitary-thyroid axis of patients with nonthyroidal illness (NTI) have not been clearly elucidated so far. Therefore, it was thought of interest to investigate this problem by determining free thyroid hormones and TSH in serum and the response of TSH to TRH in these patients. The subjects employed in this study were 71 cases with hemodialysis, 40 cases with diabetes mellitus, 24 cases with liver cirrhosis, 12 cases with various cancers, 10 cases with anorexia nervosa and 110 normal subjects as controls. The serum total protein, albumin, free T4, free T3, TSH and other parameters of thyroid function were determined, and the TRH test was performed on about 10 patients of each group. Serum TSH was not only determined by a conventional assay system, but with a highly sensitive method, and the data were compared with one another. It was found that the serum free T3 levels were significantly low in all the groups investigated, but the serum free T4 levels were significantly low only in the groups with hemodialysis, decompensated liver cirrhosis, cancers and anorexia nervosa. No significant lowering of serum free T4 was observed in the patients with diabetes mellitus, acute hepatitis and compensated liver cirrhosis. However, serum TSH levels tended to be higher in all the groups studied, though they were not significant. The response of TSH to TRH was low or delayed in about 20-50% of patients with hemodialysis, diabetes mellitus, liver cirrhosis, cancers and anorexia nervosa. It was observed that the serum rT3 concentration was significantly high in the patients with diabetes mellitus and anorexia nervosa but significantly low in the patients on hemodialysis. In the rest of the groups, there were found many cases who showed high levels of serum rT3 although they were not statistically significant. These results indicate that low concentrations of serum free T3 observed in the majority of the patients with severe NTI were, at least in part, due to the decrease in the peripheral conversion of T4 to T3 and the lowered sensitivity of the anterior pituitary to thyroid hormones and TRH.
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PMID:[Serum free thyroid hormones and response of TSH to TRH in nonthyroidal illnesses]. 310 Mar 46

Among 339 patients with anorexia nervosa and 208 with bulimia there were 11 (ten females) with both bulimia and type I diabetes. In all of them it proved impossible, often over many years, to control the wide swings in the carbohydrate metabolic state, resulting in often severe diabetic complications. From one to 15 years elapsed before a diagnosis of bulimia was made. In three patients the eating disorder had preceded the onset of manifest diabetes. Six patients did not vomit, a common sign of bulimia: they "regulated" their weight via renal glucose loss or even by manipulating insulin dosage. Psychotherapy had a favourable effect on the diabetes in six patients, three continued to need treatment, while two failed to undergo treatment.
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PMID:[Type 1 diabetes mellitus and bulimia--a life-threatening double illness]. 319 8

Patients with anorexia nervosa frequently manifest impaired glucose tolerance. However, alterations in pancreatic glucagon secretion have also been associated with alterations in diabetes mellitus. For this reason, pancreatic alpha- and beta-cell responses to glucose load were measured in 25 anorexic patients both before and after treatment. The baseline glucose challenge failed to suppress plasma glucagon levels in the patients. However, in the control subjects and patients after treatment, glucagon levels were suppressed after glucose ingestion. Plasma glucose levels during the baseline challenge were significantly higher than those of the control subjects; however, after treatment glucose responses were nearly normal. Finally, insulin responses at baseline and after treatment were lower in the patients than in control subjects. These results suggest that the impaired glucose tolerance manifested by anorexic patients may be attributable to significant alterations in both pancreatic alpha- and beta-cell secretions and in pancreatic alpha-cell and glucose interrelationships.
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PMID:Glucagon secretion in anorexia nervosa. 327 71

Twenty-nine diabetic patients (19 men, 10 women) aged 19-71 yr with newly developed painful polyneuropathy were studied prospectively for 12-18 mo. Pain remitted completely in 16 patients within 12 mo, but continued in the other 13 patients. At presentation, no differences were found in the type or prevalence of symptoms or neurophysiological measurements (electrophysiology and cardiovascular autonomic function tests) between the patients whose pain remitted and those whose pain continued. Most electrophysiological measurements improved slightly in remitting patients but deteriorated slightly in those whose pain continued to reveal a significant difference (P less than .05) between the groups on final review. Similarly, abnormal autonomic nerve function improved slightly when pain remitted but worsened or persisted in patients whose pain continued, again revealing a significant difference between the groups (P less than .05) on final review. We also observed that pain remission usually occurred if the onset of symptoms shortly followed some sudden metabolic change (e.g., rapid improvement in glycemic control, ketoacidosis, anorexia nervosa) when the duration of diabetes was relatively short or when considerable weight loss preceded the onset of pain. We suggest that remitting and chronic painful diabetic polyneuropathy have distinctive clinical features at presentation and detectable neurophysiological differences during their symptomatic evolution.
Diabetes Care 1988 Jan
PMID:Chronic and remitting painful diabetic polyneuropathy. Correlations with clinical features and subsequent changes in neurophysiology. 333 78

Several recent case reports have shown that anorexia nervosa and bulimia negatively affect glycemic control in diabetic patients. However, there have been no systematic studies to assess the prevalence of clinical or subclinical eating disorders among diabetic patients or to determine the impact of such disturbances on glycemic control. This study reports a survey of 202 adolescents, aged 12-18 yr, seen in the Diabetes Clinic, Children's Hospital of Pittsburgh, who were asked to complete the Binge Eating Scale (BES) and the EAT-26 questionnaire. Responses of diabetic patients to the EAT-26 questionnaire were compared with those of a nondiabetic control group and were related to measures of glycemic control. Diabetic subjects scored higher on the total EAT-26 than nondiabetic control subjects, ordinarily indicative of more eating pathology. However, diabetic subjects scored higher only on the dieting subscale of this questionnaire, probably reflecting adherence to the diabetes dietary regimen. Subjects with diabetes scored lower, or did not differ significantly, from nondiabetic control subjects on measures of oral control and bulimia. Among diabetic subjects, self-reported bulimic behaviors were related to poorer glycemic control. Patients with the highest scores on the BES had an average HbA1 of 13.1% compared with 11.8% for age- and sex-matched patients at the 50th percentile, and 10.8% for patients in the lowest 10th percentile. Further studies are needed to determine whether modification of these eating behaviors would improve glycemic control.
Diabetes Care
PMID:Subclinical eating disorders and glycemic control in adolescents with type I diabetes. 345 97

Recent case reports have suggested an association between anorexia nervosa and/or bulimia with insulin-dependent diabetes mellitus (IDDM). Fifty-eight females aged fifteen to twenty-two with IDDM for more than one year were assessed for the presence of eating disorders. Patients were screened for eating and weight pathology using the Eating Disorder Inventory (EDI) and Eating Attitudes Test-26 (EAT-26). Glycosylated hemoglobin (HbA1) was measured to assess metabolic control. Subjects who scored above the cut-off points associated with eating and weight pathology were interviewed. Clinically significant eating and weight pathology was found in 20.7 percent of the population. Of these subjects, anorexia nervosa was found in 6.9 percent and the syndrome of bulimia, based on DSM-III criteria, was found in 6.9 percent. In patients with bulimia, there was a strong inverse correlation between bulimic symptoms and metabolic control. These findings suggest that anorexia nervosa may be more common in female adolescents with IDDM than in nondiabetic populations and that bulimic symptoms may be a risk factor for poor metabolic control.
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PMID:Eating disorders in female adolescents with insulin dependent diabetes mellitus. 345 20

Review of recent literature with emphasis on growth, development and epidemiology of eating disorders and diabetes reveals many common features of the conditions. Thus we hypothesize more concurrence than would occur by chance alone. At present epidemiological evidence is inconclusive, but prevalence of eating disorder seems increased in insulin dependent diabetes mellitus (IDDM). Over a period of 25 years five cases (all female) of diabetes were found in a consecutive series of 242 patients with eating disorders treated at the Child Psychiatric and Psychiatric Clinics at Rigshospitalet, Copenhagen, Denmark. This is a six-fold increase in prevalence of IDDM. IDDM preceded eating disorder (anorexia nervosa (AN)/bulimia(B)) in four of the five cases, and contributed significantly to the psychopathology found: the more, the earlier the age at onset of IDDM. Treatment proved difficult and the outcome seems serious. At latest contact four cases had manifest eating disorders and three of these had unstable and complicated IDDM as well. The patients' adaptation to IDDM seems crucial for the outcome.
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PMID:Anorexia nervosa/bulimia in diabetes mellitus. A review and a presentation of five cases. 360 30

Tests to measure the volume of gastric contents are necessary to determine the nature of a gastric emptying disorder. The conditions that can affect gastric emptying are as varied as peptic ulcer disease, achlorhydria, viral and bacterial infections of the stomach, diabetes, scleroderma, anorexia nervosa, and CNS lesions; some patients experience gastric emptying problems after surgery for peptic ulcer disease. The future of electrical pacing of the stomach and perhaps the gastrointestinal tract in general is very exciting, as is the future use of antiarrhythmic drugs.
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PMID:Gastric emptying disorders. Tests and treatments. 380 70


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