Trastornos de la conducta alimentaria en adolescentes de ambos sexos con y sin diabetes mellitus tipo 1
Although eating disorders (ED) are common in late adolescent diabetic patients, the occurrence in younger populations, particularly male diabetic patients, is not well documented (1,2). The prevalence was studied in 60 boys and 38 girls (13.78+/-1.05 years; range: 12-16) with diabetes duration 1.5+/-3.35 years, and 321 boys and 254 girls as non-diabetic peers (13.73+/-0.63 years; range: 12-16).
Patients and peer completed the Spanish validated version of the Eating Attitudes Test (EAT-40) (3). The semistructured Eating Disorder Examination interview (EDE) (4) was held for those with an EAT-40 over 30 (13 diabetic patients, 57 non-diabetic peers) and an additional randomly-selected population (24 diabetic patients, 57 non-diabetic peers) with an EAT-40 score under 30. ED were classified as clinical (5) and subthreshold (1). SPSS version 9.0 was used for statistical analysis.
No cases of anorexia or bulimia were found. Eating disorders not otherwise specified (EDNOS) were more prevalent in diabetic patients than peers: boys (1.7% vs 0.9%, OR 1.7, CI 95%: 0.2 to 17.6) and girls (5.3% vs 1.6%, OR 3.2, CI 95%: 0.62 to 17.2). Subthreshold ED were more prevalent in male diabetic patients than non-diabetic peers ( 10% vs 4.4%, OR 2.4, CI 95% 0.9 to 6.6), with no differences between female diabetic patients and non-diabetic peers (10.5% vs 9.9%, OR 1.1, CI 95%: 0.4 to 3.2). Male diabetic patients had 2.4 times increased risk for subthreshold ED than non-diabetic peers. No ED were observed in the 24 diabetic patients and 57 non-diabetic peers with EAT-40 scores under 30. Glycated hemoglobin values were higher in diabetic patients with ED (9.8+/-0.42 % and 5.63+/-2.76 SD, n=13) than those without (8.4+/-1.5% and 5.09+/-2.73 SD, n=85); p=0.049.
Although no cases of anorexia or bulimia were found, EDNOS and subthreshold ED were detected in younger diabetic patients of both sexes. The higher glycated hemoglobin levels found in diabetic patients with ED suggest poor metabolic control and increased risk for later vascular complications (6). Further studies including large series of patients are necessary to confirm these preliminary results; however, our data underline the need for careful surveillance in young diabetic patients of both sexes for these incipient ED to be detected promptly and prevented.
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Advisor:Carrascosa, Antonio; Raich, Rosa M.
School:Universitat Autónoma de Barcelona
Source Type:Master's Thesis
Keywords:451 departament de psicologia la salut i social
Date of Publication:02/13/2004