Anorexia nervosa complicated by diabetes mellitus: the case for permissive hyperglycemia.
The coexistence of Type 1 Diabetes Mellitus and anorexia nervosa results in an increased incidence of known diabetic complications such as retinopathy and nephropathy, presumably because blood glucose is difficult to control within the throes of comorbid anorexia nervosa. In addition, even when a diabetic patient with anorexia nervosa has committed to resolving his or her eating disorder, glucose control is again difficult and fraught with complexity and peril as will be highlighted in the following case report. Prudence dictates that strict glucose control is not indicated for the relatively short period of time that constitutes the early stage of refeeding in a patient with severe anorexia nervosa. Rather, "permissive hyperglycemia" may be the more optimal course to pursue, as a clinical strategy which is considerate of both the criticality of the refeeding treatment plan and of the long-term nature of the diabetic illness.
Department of Medicine, University of Colorado Health Sciences Center and Denver Health.
Carrie
C
Brown
Philip S
PS
Mehler
D000856:Anorexia Nervosa / Q000150:complications* / Q000178:diet therapy; D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia; D007003:Hypoglycemia / Q000139:chemically induced / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D055677:Refeeding Syndrome / Q000209:etiology; D055815:Young Adult
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose
anorexia nervosa; diabetes mellitus; hyperglycemia; permissive