title: Women with insulin-dependent diabetes mellitus (IDDM) complicated by eating disorders are at risk for exacerbated alterations in lipid metabolism.
abstract: OBJECTIVE
  To examine lipid parameters that are affected in women with insulin-dependent diabetes mellitus (IDDM) who engaged in disordered eating behaviours.
  
  
  METHODS
  Randomized, unmatched.
  
  
  METHODS
  Tertiary care.
  
  
  METHODS
  Ninety women (18-46 y) with IDDM.
  
  
  METHODS
  Classification of subjects based on severity of eating disorder: clinical (n = 14), subclinical (n = 13) and control (n = 63). Blood was analysed for glycosylated haemoglobin (HbA1c) and serum for triglycerides and cholesterol. Carotenoid and tocopherol concentrations were analysed by high performance liquid chromatography (HPLC). Dietary intake was assessed by the National Cancer Institute food frequency questionnaire.
  
  
  RESULTS
  HbA1c was significantly increased im women demonstrating clinical and subclinical symptoms compared to control (10.4 +/- 2.6, 10.0 +/- 1.5 and 8.3 +/- 1.6%, respectively, P < 0.05). Triglycerides concentrations were significantly increased in women with subclinical eating disorders compared to controls. In women who intentionally omitted or reduced insulin, triglyceride cholesterol and HbA1c were significantly increased compared to controls. Women with IDDM and eating disorders who exhibited bulimic behaviours consumed significantly more energy, total fat and cholesterol compared to controls and women with eating disorders who were restrained eaters.
  
  
  CONCLUSIONS
  While IDDM is known to perturb lipid metabolism, these data demonstrate that eating disorders, in combination with IDDM, results in additional alterations in lipid metabolism.
authors.affiliation: Department of Nutritional Sciences, University of Connecticut, Storrs 06269, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Affenito
authors.forename: C J
authors.initials: CJ
authors.lastname: Lammi-Keefe
authors.forename: S
authors.initials: S
authors.lastname: Vogel
authors.forename: J R
authors.initials: JR
authors.lastname: Backstrand
authors.forename: G W
authors.initials: GW
authors.lastname: Welch
authors.forename: C H
authors.initials: CH
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002032:Bulimia; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D004038:Diet, Reducing; D002149:Energy Intake; D001068:Feeding and Eating Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D050356:Lipid Metabolism; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin