There is a high prevalence of eating disorders among girls with type 1 diabetes according to Canadian researchers. They also found that eating disturbances in this population are likely to persist over time. Dr. Patricia A. Colton, of University Health Network, Toronto, Ontario, and colleagues report on a 5-year longitudinal study of eating disturbances in girls with type 1 diabetes.
At baseline of this study, higher rates of disturbed eating behavior were observed in girls with type 1 diabetes between the ages of 9 and 13 years than in non-diabetic control patients (8% versus 1%). The current report summarizes data from baseline to 5-year follow-up.
Overall, 126 girls participated at baseline, and this number steadily declined to 98 at 5 years. The mean age was 11.8 years at baseline and 16.5 years at 5 years.
Of the 98 girls who participated at 5 years, 48 (49.0%) reported current disturbed eating behavior. Specifically, 43 of the 98 girls reported active dietary restraint, 6 reported binge-eating episodes, 3 reported self-induced vomiting, 3 reported insulin omission, and 25 reported intense, excessive exercise for weight control. A total of 13 girls met the criteria for eating disorders.
The authors note that A1C was not higher in subjects with disturbed eating behavior (8.7% versus 8.4%). However, a trend for higher A1C was observed among those with an eating disorder (9.1% versus 8.5%; p = 0.08). Subjects with disturbed eating behavior had higher BMI (26.1 versus 23.5; p = 0.001).
Dr. Colton stated that, "Eating disturbances early in the study, in the pre-teen years, were very likely to persist over time; 92% of girls with eating disturbances detected early in the study continued to report eating disturbances later in their teen years."
"This study contributes to the growing understanding of the close relationship between physical health and mental health in individuals with diabetes," Dr. Colton continued. "In particular, eating disturbances are very common and persistent in girls and women with type 1 diabetes, and can arise in even pre-teen girls," she noted.
These results suggest that screening for eating disturbances in individuals with type 1 diabetes should start in the pre-teen years. "Individuals with diabetes who are struggling with eating disturbances should receive early support and treatment to prevent the development of full-syndrome eating disorders and the medical risks associated with them," Dr. Colton advised.
"It is often hard for individuals to tell someone that they have an eating disorder, and so sensitivity to body image issues, body dissatisfaction and eating disturbances, both at home and in the clinic setting, is crucial to helping these individuals seek appropriate help and support in optimizing their health and reaching their full potential," she concluded.
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Diabetes Care Nov., 2007;30:2861-2862.