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When Binge Eating Disorder May Not Be a Disorder

Nov 16, 2015

Male, 72 years of age, type 2 diabetes, overweight secondary to binge eating disorder. Taking glipizide 20mg daily and metformin 1,000mg twice daily.

Hypoglycemic unawareness. Not regularly checking glucose. Recent A1C 6.8%


  • Stop glipizide
  • Start glimiperide 1mg, Invokana 100mg daily
  • Regular glucose monitoring, fasting, after meals and when feels like going to binge

Return visit:

  • Felt better overall
  • Binging in control
  • Glucose levels-Fastings 70 to 80’s, pre dinner 50-60s. No symptoms hypoglycemia


  • Continue metformin and Invokana
  • Stop glimiperide
  • Continue glucose monitoring, meal and exercise plan.
  • Visit 2 weeks

Lessons Learned:

  • If/when someone is being treated for binge eating disorder, look at the whole picture.
  • If/when someone who has type 2 diabetes has hypoglycemic unawareness, use medications that don’t cause, or be very careful when using medications that cause, hypoglycemia. Teach patient to check glucose levels regularly.
  • If patient who is overweight or has obesity, assess for meds that cause hypoglycemia. Hypoglycemia can cause overeating which can cause weight gain. Again, choose options that do not cause hypoglycemia.


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