The duration of severe insulin omission is the factor most closely associated with the microvascular complications of Type 1 diabetic females with clinical eating disorders

Int J Eat Disord. 2008 Apr;41(3):259-64. doi: 10.1002/eat.20498.

Abstract

Objective: To investigate which features of eating disorders are associated with retinopathy and nephropathy in Type 1 diabetic females with clinical eating disorders.

Method: Participants were 109 Type 1 diabetic females with clinical eating disorders diagnosed by the structured clinical interview for DSM-IV (bulimia nervosa [n = 70], binge-eating disorder [n = 28], anorexia nervosa [n = 7], and eating disorder not otherwise specified [n = 4]). Retinopathy and nephropathy were screened and demographic, medical, and eating disorder related factors were investigated. To identify the factors associated with each complication, logistic regression analysis was done.

Results: Duration of severe insulin omission and duration of Type 1 diabetes were significantly associated with retinopathy (odds ratios = 1.35 and 1.23, respectively) and nephropathy (odds ratio = 1.35 and 1.21, respectively) in multivariate regression analyses.

Conclusion: Of the various problematic behavioral factors related to eating disorders, the duration of severe insulin omission was the factor most closely associated with the retinopathy and nephropathy of Type 1 diabetic females with clinical eating disorders by multivariate analysis. This finding may help patients who deliberately omit insulin become aware of medical risk of insulin omission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Anorexia Nervosa / epidemiology*
  • Body Mass Index
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Nephropathies / epidemiology*
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Retinopathy / epidemiology*
  • Diabetic Retinopathy / physiopathology*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Insulin / metabolism*
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Refusal / statistics & numerical data*

Substances

  • Glycated Hemoglobin A
  • Insulin