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Scheuing, Nicole; Bartus, Béla; Berger, Gabriele; Haberland, Holger; Icks, Andrea; Knauth, Burkhild; Nellen-Hellmuth, Nicole; Rosenbauer, Joachim; Teufel, Martin; Holl, Reinhard W.

Clinical Characteristics and Outcome of 467 Patients With a Clinically Recognized Eating Disorder Identified Among 52,215 Patients With Type 1 Diabetes: A Multicenter German/Austrian Study

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  • Medientyp: E-Artikel
  • Titel: Clinical Characteristics and Outcome of 467 Patients With a Clinically Recognized Eating Disorder Identified Among 52,215 Patients With Type 1 Diabetes: A Multicenter German/Austrian Study
  • Beteiligte: Scheuing, Nicole; Bartus, Béla; Berger, Gabriele; Haberland, Holger; Icks, Andrea; Knauth, Burkhild; Nellen-Hellmuth, Nicole; Rosenbauer, Joachim; Teufel, Martin; Holl, Reinhard W.
  • Erschienen: American Diabetes Association, 2014
  • Erschienen in: Diabetes Care
  • Sprache: Englisch
  • DOI: 10.2337/dc13-2156
  • ISSN: 0149-5992; 1935-5548
  • Schlagwörter: Advanced and Specialized Nursing ; Endocrinology, Diabetes and Metabolism ; Internal Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>To compare clinical characteristics and outcome of type 1 diabetes mellitus (T1DM) between patients with and without a clinically recognized eating disorder (ED).</jats:p></jats:sec><jats:sec><jats:title>RESEARCH DESIGN AND METHODS</jats:title><jats:p>A total of 52,215 T1DM patients aged 8 to &amp;lt;30 years from the prospective diabetes data acquisition system DPV were analyzed. A total of 467 patients had an additional diagnosis of ED according to DSM-IV criteria (anorexia nervosa [AN], n = 141 [female: 94.3%]; bulimia nervosa [BN], n = 62 [90.3%]; and EDs not otherwise specified, including binge-eating disorder [EDNOS], n = 264 [74.2%]). Groups were compared using multivariable regression. Cox proportional hazard ratios were calculated for the association between ED and retinopathy.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>After adjustment for age, sex, and duration of diabetes, patients with ED revealed higher HbA1c (no ED vs. AN, BN, or EDNOS, respectively: 8.29 ± 0.01% [67.1 ± 0.1 mmol/mol] vs. 8.61 ± 0.15% [70.6 ± 1.6 mmol/mol], 9.11 ± 0.23% [76.1 ± 2.5 mmol/mol], or 9.00 ± 0.11% [74.9 ± 1.2 mmol/mol]) and a higher rate of pathological insulin injection sites (48.4 vs. 64.3, 64.1, or 62.1%). Furthermore, ketoacidosis (5.7 ± 0.1 vs. 12.1 ± 2.1, 18.0 ± 4.1, or 12.9 ± 1.6 events per 100 person-years) and hospitalization (54.9 ± 0.3 vs. 89.3 ± 6.0, 132.0 ± 12.7, or 91.0 ± 4.4 per 100 person-years) were more common, and duration of hospital stay was longer (4.81 ± 0.01 vs. 11.31 ± 0.21, 18.05 ± 0.48, or 8.44 ± 0.13 days per year). All P values were &amp;lt;0.05. Patients with BN and EDNOS had a 2.5-fold (95% CI 1.3–4.8) and a 1.4-fold (0.8–2.3) higher risk for retinopathy, whereas AN patients had no increased risk (0.9 [95% CI 0.4–2.3]).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Diabetes health care professionals should be aware of comorbid EDs in pediatric/young-adult T1DM patients. An ED diagnosis is associated with worse metabolic control and higher rates of diabetes complications.</jats:p></jats:sec>
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