June 21, 2000 -- Eating disorders are more than twice as likely among teen-age girls with type 1 diabetes as in nondiabetic teens, elevating their blood sugar in the short run and tripling their risk of vision loss in the future, a Canadian study shows.
"Psychological disturbances in eating behavior pose health risks for everyone, but are especially dangerous for people with diabetes," says Gary Rodin, MD, co-author of the study published in the British Medical Journal. "Underdosing of insulin has the same effect on weight loss as purging or vomiting, and is considered to be an eating disorder," adds Rodin, professor and chief of psychiatry at the University of Toronto.
To determine whether eating disorders are more common in diabetics, Rodin and colleagues surveyed almost 1,500 girls ranging from 12 to 19 years of age. Those with type 1 diabetes, who need insulin injections to live, were compared to nondiabetics on the basis of their attitudes toward eating attitudes and their body mass. Blood samples also were obtained from the diabetic participants.
The researchers found that diabetic teens were 2.4 times more likely to have eating disorders, with 11% of them taking less than their prescribed dose of insulin. Overall, 10% of the diabetic teens met the definition for having an eating disorder.
Those with eating disorders also had some abnormal blood results, which indicated these girls are at increased risk for complications of diabetes, such as eye and kidney disease. The findings come on the heels of an American study, published in the Journal ofDevelopmental and Behavioral Pediatrics, which found that a third of the teen-age girls with type I diabetes had symptoms of eating disorders. Also noting low self-esteem and poor body image among these girls, the authors of that study suggest that diet restrictions may increase the risk of eating disorders. And doctors agree.
"Diabetics are regimented in what they eat and when, often causing them to overfocus on food, especially weight-conscious teen-age girls," says diabetes specialist Mark Rappaport, MD, PhD, an Atlanta-based pediatric endocrinologist. "But eating disorders don't develop unless girls are already at high risk," he adds, citing depression as a factor.
Rappaport tells WebMD that insulin underdosing not only causes high blood sugar and capillary changes, but other serious medical problems as well. "Taking less insulin than prescribed affects the way fat is broken down, causing the blood to become too acidic," Rappaport says. "It's called ketoacidosis, and it can lead to coma and even death."
Rappaport urges parents of diabetics to report suspected eating disorders to a doctor. "It's a complicated problem that requires a lot of coordination between diabetes specialists and mental health professionals," he says. "So by all means, discuss suspected eating disorders with your child's physician as soon as possible."
- Among adolescent girls, eating disorders are more than twice as common among those with type 1 diabetes, according to a new study.
- In this population, eating disorders can increase blood sugar levels, affect vision in the long term, and cause other potentially serious medical problems.
- Diabetes doesn't cause girls to develop an eating disorder, but the extra focus on food can trigger the condition for those who already are at high risk.