Study on Disturbed eating behavior in type 1 women
A recent study in November's Diabetes Care found disturbed eating behaviors are far more prevalent in women than men and are more prevalent for those who have diabetes than the average population.
Disturbed Eating Behaviors (DEB), which includes sub-threshold and full-syndrome eating disorders (ED's) and mild eating disturbances, are far more common in girls and women with type 1 diabetes than their nondiabetic cohorts. DEB is associated with poor metabolic control, increased hospitalizations, and diabetes-related medical complications. At the baseline of this five-year longitudinal study, 8% of the type 1 diabetes girls age 9 to 13 versus 1% of the nondiabetic control group had DEB. The incidence of the baseline DEB continued in one-half of those one year later.
The study results found that the expected relationship between DEB and poor metabolic control were not evident at five years but that there was a trend to higher A1c's in those patients with eating disorders. This shows that early intervention might be able to prevent the worsening metabolic control in these patients.
In addition, the study found that higher body mass index (BMI) and the incidence of DEB were strongly associated. Higher BMI is associated with dieting in the general population and girls and women with type 1 are generally heavier than their peers. This study did not have a comparison group but 44.9% of the participants were overweight and obese at the five year followup. This was twice the rate seen in the Canadian Community Health Survey for comparison.
A management dilemma exists for physicians and other healthcare providers because the dietary restraint and higher weight are risk factors for the development of an eating disorder and the associated health consequences. This study recommends normalizing eating behaviors and enhancing self-esteem based on one's personal attributes. Screening for eating disorders should begin early and be conducted annually.
Signs of eating disorders are food restriction behaviors, purging, excessive exercise, diuretic or laxative abuse, and binge eating. If you or an acquaintance observe these problems please seek medical advice.
Source: Diabetes Care November 2007