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

IDDM and eating disorders are common conditions in young women. Whether a specific association exists between these two disorders remains controversial. Some studies have suggested an increased incidence of eating disorders in young women with IDDM, whereas others have not detected such an increase. These differences may be attributable, at least in part, to methodological issues in study design, measurement tools, and relatively small sample sizes. Whether the prevalence of eating disorders in IDDM is increased will be resolved only by larger studies that use standardized diagnostic interviews. We suspect that certain aspects of IDDM and its management may trigger the expression of an eating disorder in susceptible individuals. Required dietary restraint and weight gain related to diabetes management are the factors most likely to be implicated. Eating disorders are relatively common in young women with IDDM and may contribute to impaired metabolic control with hypoglycemia and DKA, and to long-term microvascular complications of diabetes. Omission or reduction of required insulin, an extremely common means of weight control in these young women, is likely an important factor in this regard. Further research is required to determine more precisely the relationship between IDDM and eating disorders, and the effects of eating disorders on metabolic control and chronic complications of IDDM.
Diabetes Care 1992 Oct
PMID:Eating disorders and IDDM. A problematic association. 142 9

This report describes the challenging clinical problem of the coexistence of an eating disorder and diabetes mellitus in the same patient. Review of prior cases reveals young female, anorexic diabetics are most frequently reported. A review of previously published surveys indicates the prevalence of eating disorders among diabetics is 11 percent. Relevant clinical interactions from the biologic, psychologic and family perspectives are reviewed.
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PMID:Eating disorders among diabetics: a case report and literature review. 152 27

Anorexia nervosa and bulimia nervosa are complex psychosomatic illnesses for which there may be significant biomedical diatheses and sequelae. This paper reviews these biomedical variables, focusing on the medical and nutritional assessment and management of patients with eating disorders and the medical complications that arise in these patients. The paper then examines the relationship between medical illness and eating disorders, including the medical misdiagnoses often given to these patients and the way in which a chronic medical condition such as diabetes mellitus predisposes a patient to an eating disorder. The relationship between eating disorders and pregnancy is also discussed. Through an understanding of these biomedical issues, iatrogenesis can be prevented and treatment can be improved.
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PMID:Biomedical variables in the eating disorders. 228 28

Reactive hypoglycemia is a relatively uncommon meal-induced hypoglycemic disorder. Most patients with adrenergic-mediated symptoms have a diagnosis other than reactive hypoglycemia. In many patients with this self-diagnosis, other disorders can be attributed as a cause for symptoms, especially neuropsychiatric disease. The continued use of the terminology "functional hypoglycemia" only contributes vagueness to our correct understanding of this metabolic condition. There are a number of conditions associated with postprandial hypoglycemia. One category is the reactive hypoglycemias, which occur in patients with diabetes mellitus (diabetes reactive hypoglycemia), gastrointestinal dysfunction (alimentary reactive hypoglycemia), hormonal deficiency states (hormonal reactive hypoglycemia), and a large patient group characterized as having idiopathic reactive hypoglycemia. Of these causes the alimentary, hormonal, and diabetic patients are less disputed, whereas the idiopathic reactive hypoglycemic group has been referred to as a "nondisease" group. Characteristic alterations in insulin secretion accompany each of these conditions. In bona fide patients, dysinsulinism or hyperinsulinism usually accounts for the hypoglycemia. Some patients may have increased insulin sensitivity, but this association is doubtful or very rare. Patients with this meal-related eating disorder are characterized as ingesting excessive quantities of refined carbohydrate. In the research setting, the disorder can easily be elicited with the oral glucose tolerance test. However, to establish clinical relevance, the hypoglycemia needs documentation in the home setting with measurements of blood glucose during a postpradial symptomatic episode. The reactive hypoglycemic patients are frequently confused with patients with underlying psychiatric illness. Both syndromes are similar, with adrenergic-mediated symptoms and a common characteristic personality as noted on Minnesota Multiphasic Personality Inventory (MMPI) testing. Patients with bona fide meal-related reactive hypoglycemia should be treated primarily with dietary restriction of refined carbohydrates; other patients may require medications.
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PMID:Reactive hypoglycemia. 264 26

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

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

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

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

The evidence suggests that poor diabetic control in adolescence is often associated with omissions of insulin, overeating and other failures in adherence to the treatment regime in the context of some kind of emotional disturbance. Six young patients with diabetes mellitus and an eating disorder (anorexia nervosa or bulimia), who failed to control their diabetes in order to lose weight and to compensate for bulimic episodes, are discussed. Other noteworthy features were their feelings of hopelessness and their unco-operativeness with treatment. Our knowledge of the pathogenesis of anorexia nervosa and of the special problems faced by diabetic adolescents would lead to a prediction that a combination of the two disorders should arise more often than could be accounted for by chance.
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PMID:Anorexia nervosa and bulimia in diabetics. 639 33


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