Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Diabetes. Nov 15, 2011; 2(11): 189-195
Published online Nov 15, 2011. doi: 10.4239/wjd.v2.i11.189
Disordered eating behaviors in type 1 diabetic patients
Alejandra Larrañaga, María F Docet, Ricardo V García-Mayor
Alejandra Larrañaga, Ricardo V García-Mayor, Eating Disorders Unit, University Hospital of Vigo, 36204 Vigo, Spain
María F Docet, Nutrition Section, University Hospital of Vigo, 36204 Vigo, Spain
Author contributions: Larrañaga A, Docet MF and García-Mayor RV contributed equally to this work.
Supported by a grant from INCITE, Consellería Innovación e Industria, Galician Government
Correspondence to: Ricardo V García-Mayor, Professor, Eating Disorders Unit, University Hospital of Vigo, PO Box 1691, 36204 Vigo, Spain. ricardo.garcia.mayor@sergas.es
Telephone: +34-986-816000 Fax: +34-986-816029
Received: August 27, 2011
Revised: October 5, 2011
Accepted: October 22, 2011
Published online: November 15, 2011
Abstract

Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.

Keywords: Anorexia nervosa; Bulimia nervosa; Eating disorders not otherwise specified; Disordered eating behaviors; Type 1 diabetes