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

Insulin sensitivity was studied using the euglycemic insulin clamp technique in 5 female patients with anorexia nervosa and 4 females with bulimia. The results were compared with those of 15 male patients with non-insulin-dependent diabetes mellitus. Euglycemic insulin clamp is performed for 2 h using the Biostator, during which time insulin was infused at a rate of 0.77 mU kg-1 min-1. Fasting plasma glucose and immunoreactive insulin tended to be lower in patients with anorexia nervosa than in those with bulimia (69.8 +/- 6.7 vs 75.9 +/- 7.7 mg/dl, and 5.9 +/- 2.0 vs 9.8 +/- 3.4 U/ml). The mean metabolic clearance rate (MCR) was 9.2 +/- 3.9 ml kg-1 min-1 for patients with anorexia nervosa, 5.1 +/- 2.2 ml kg-1 min-1 for patients with bulimia, and 3.8 +/- 0.3 ml kg-1 min-1 for patients with diabetes mellitus. However, one anorectic had a significantly high MCR. One anorectic and 3 bulimics had a significantly low MCR. These results suggest that insulin sensitivity varied in patients with anorexia nervosa, whereas it tended to decrease in some patients with bulimia but not to the same degree as in patients with diabetes mellitus.
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PMID:Insulin sensitivity in patients with anorexia nervosa and bulimia. 218 78

All insulin-dependent diabetics between the ages of 16 and 25 years attending the diabetic clinic at the Royal Infirmary, Edinburgh, (152 women and 139 men) were asked to complete the EAT, the EDI, and the GHQ, and to provide a control subject (sibling or close friend) of similar age who would do likewise. Marked differences were found between diabetic women (but not men) and their controls in eating attitudes, in many of the psychological characteristics associated with eating disorders, and in GHQ scores. Although some of the women had classic anorexia nervosa or bulimia, others with abnormal eating attitudes did not fulfil the formal criteria. Overall, diabetics were significantly heavier than controls but the differences in eating attitudes were not eliminated by correcting for overweight. Abnormal scores were associated with high HbA1 levels and independently with retinopathy. The weight gain and psychological effects of diabetes are identified as probably of aetiological importance in the abnormal eating attitudes of young diabetic women.
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PMID:Abnormal eating attitudes in young insulin-dependent diabetics. 261 74

Case reports and empirical studies suggest that young women with insulin-dependent diabetes mellitus (IDDM) may be at high risk for developing eating disorders. In this study, self-reports of binge eating and purging from 59 IDDM women (aged 18-30 yr) were obtained. Most participants (58%) reported that they went on eating binges, and 12% met the DSM-III criteria for a diagnosis of bulimia. Nearly 40% admitted to controlling their weight by insulin purging, and 13.5% reported purging by other means. A group of bulimic participants had mean scores on an eating disorder questionnaire in the pathological range. Bulimic symptoms were positively related to reports of hospitalizations, episodes of ketoacidosis, and psychological symptoms. Implications of these results on the medical management of young women with IDDM are discussed.
Diabetes Care 1989 Oct
PMID:Binge eating and purging in young women with IDDM. 279 24

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

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

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

The frequency of anorectic/bulimic disturbances in a sample of male and female subjects with insulin-dependent diabetes mellitus was compared to that of male and female normal controls. The results suggest an overrepresentation of anorexia/bulimia in the female diabetics. Prevalence of eating disorders was determined from the scores on the Eating Attitudes Test. As a group, the female diabetics had significantly (p less than .05) higher scores on the test, suggesting a greater "awareness" of topics related to food and eating. The results are discussed within a risk-factor model, in which insulin-dependent diabetes mellitus may be viewed as one factor in the development of eating disorders.
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PMID:Eating disorders in patients with insulin-dependent diabetes mellitus. 377

Between 1978 and 1985, we conducted a prospective study of 21 patients who survived several attacks of pancreatitis and were diagnosed as having primary hyperlipidemia. None of the patients suffered from chronic alcoholism, primary diabetes, or cholelithiasis or was receiving prolonged steroid therapy. Lowering of plasma lipid values toward normal was achieved in all patients following a program of combined dietary and drug (bezafibrate) therapy. Five patients had recurrent episodes of pancreatitis during the treatment program. These patients were diagnosed subsequently as suffering from bulimia and were all given cognitive behavioral therapy. One patient died following an attack of pancreatitis. An underlying eating disorder should be suspected in patients who relapse after treatment for pancreatitis and hyperlipidemia. Multidisciplinary treatment should be used in these patients to improve therapeutic efficacy and uncover behavioral patterns that have a direct impact on their life expectancy.
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PMID:Bulimia. An underlying behavioral disorder in hyperlipidemic pancreatitis: a prospective multidisciplinary approach. 382 58


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