title: Subclinical and clinical eating disorders in IDDM negatively affect metabolic control.
abstract: OBJECTIVE
  To characterize the relationship of subclinical and clinical eating disorders to HbA1c values in women with IDDM.
  
  
  METHODS
  Ninety women with IDDM (18-46 years of age) were recruited from diabetes clinics throughout Connecticut and Massachusetts. Subjects were categorized into one of three groups according to the Diagnostic Statistical Manual of Mental Disorders (DSM-III-R) criteria for eating disorders as follows: the clinical group (n = 14), the subclinical group (partially fulfilling the diagnostic criteria; n = 13), and the control group (n = 63). Group differences in the degree of dietary restraint, binge eating, and bulimic behaviors and weight, shape, and eating concerns were assessed with the Eating Disorder Examination (EDE) and the Bulimia Test Revised (BULIT-R).
  
  
  RESULTS
  Women with subclinical and clinical eating disorders had clinically elevated HbA1c results and more diabetes-related complications, compared with the control subjects. The severity of bulimic behaviors, weight concerns, reduced BMI, and decreased frequency of blood glucose monitoring were associated with elevated HbA1c.
  
  
  CONCLUSIONS
  HbA1c may have clinical utility in the identification of eating disorder behavior in females with IDDM. Health care professionals should be aware of the potent effect of subclinical and clinical eating behaviors including insulin misuse in weight-conscious women with IDDM who have poor glycemic control.
authors.affiliation: Department of Nutritional Sciences, University of Connecticut, Storrs 06269, USA. affenito@uconnvm.uconn.edu
authors.forename: S G
authors.initials: SG
authors.lastname: Affenito
authors.forename: J R
authors.initials: JR
authors.lastname: Backstrand
authors.forename: G W
authors.initials: GW
authors.lastname: Welch
authors.forename: C J
authors.initials: CJ
authors.lastname: Lammi-Keefe
authors.forename: N R
authors.initials: NR
authors.lastname: Rodriguez
authors.forename: C H
authors.initials: CH
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin