The duration of severe insulin omission is the factor most closely associated with the microvascular complications of Type 1 diabetic females with clinical eating disorders.
OBJECTIVE
To investigate which features of eating disorders are associated with retinopathy and nephropathy in Type 1 diabetic females with clinical eating disorders.


METHODS
Participants were 109 Type 1 diabetic females with clinical eating disorders diagnosed by the structured clinical interview for DSM-IV (bulimia nervosa [n = 70], binge-eating disorder [n = 28], anorexia nervosa [n = 7], and eating disorder not otherwise specified [n = 4]). Retinopathy and nephropathy were screened and demographic, medical, and eating disorder related factors were investigated. To identify the factors associated with each complication, logistic regression analysis was done.


RESULTS
Duration of severe insulin omission and duration of Type 1 diabetes were significantly associated with retinopathy (odds ratios = 1.35 and 1.23, respectively) and nephropathy (odds ratio = 1.35 and 1.21, respectively) in multivariate regression analyses.


CONCLUSIONS
Of the various problematic behavioral factors related to eating disorders, the duration of severe insulin omission was the factor most closely associated with the retinopathy and nephropathy of Type 1 diabetic females with clinical eating disorders by multivariate analysis. This finding may help patients who deliberately omit insulin become aware of medical risk of insulin omission.
Takii
Masato
M
Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. takii@cephal.med.kyushu-u.ac.jp
Uchigata
Yasuko
Y
Tokunaga
Shoji
S
Amemiya
Naoko
N
Kinukawa
Naoko
N
Nozaki
Takehiro
T
Iwamoto
Yasuhiko
Y
Kubo
Chiharu
C
D000328:Adult; D017668:Age of Onset; D000856:Anorexia Nervosa / Q000453:epidemiology*; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016312:Treatment Refusal / Q000706:statistics & numerical data*
D006442:Glycated Hemoglobin; D007328:Insulin