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Eating disorder is common - and retinopathy

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INSÄNT AV N Engl J Med 1997;336:1849-1854,1905-1906 DEN 27 :e juni, 1997 kl 20:56

Disordered Eating Common In Young Women With Diabetes

Eating disorders, such as dieting or intentional
omission of insulin to control weight, are common and persistent in young women
with type 1 diabetes, and increase the risk of developing diabetic retinopathy.

The findings are reported by Dr. Anne C. Rydall of the Toronto Hospital. She and
her colleagues there and elsewhere in Ontario, Canada, followed 91 young women
with insulin-dependent diabetes for 4 to 5-years . The investigators looked
specifically at the prevalence and development of eating disorders in this cohort,
and the effects of such disorders on metabolic control and microvascular
complications of diabetes.

At baseline, 26 (29%) of the group had highly or moderately disordered eating
behavior; it persisted in 16 and improved in 11 over the follow-up period. During
the study, 14 subjects developed eating disorders. "The most striking finding of
this study," according to the report in the June 26 issue of The New England
Journal of Medicine, "...is that some degree of retinopathy was present at
follow-up in more than 85 percent of young women with IDDM who had highly
disordered eating at baseline, as compared with 43 percent of those with
moderately disordered eating and only 24 percent of those with nondisordered
eating."

Since these disorders are "...highly predictive of poor metabolic control and
subsequent complications," the authors suggest routine screening for eating
disorders in young female diabetics, followed by intervention when necessary.

Elsewhere in the journal, editorialists Drs. Gareth Williams and Geoffrey V. Gill
of the Fazakerley Hospital in Liverpool, UK, suggest that the high rate of eating
disorders found in young women with diabetes may not be entirely unexpected.
They write, "[T]he general body-image problems that confront teenage girls are
probably compounded by strong advice to patients with diabetes to remain thin and
by the obesity-promoting effects of insulin, especially at the high dosages that tend
to be used in adolescents."

N Engl J Med 1997;336:1849-1854,1905-1906.
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www red DiabetologNytt Medical reuter

• Re: Eating disorder is common - and retinopathy Joslin Diabetes Center, Boston, USA____ Tid:10:02, Datum:28/6/97 (0)