Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California.
Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California.
Endocr Pract. 2021 Feb;27(2):158-164. doi: 10.1016/j.eprac.2020.10.005. Epub 2020 Dec 13.
To familiarize health care providers with diagnosis and treatment of binge-eating disorder (BED), a common comorbidity of type 2 diabetes (T2DM).
Literature review of binge eating and T2DM. Key words used in search include BED, T2DM, obesity, and treatment.
The prevalence of BED in patients with T2DM appears to be much higher than the 2% to 3.5% prevalence seen in the general population. Studies suggest that up to 20% of patients with T2DM have an underlying eating disorder, the most common of which is binge eating. BED is probably underdiagnosed, even though there are multiple simple tools that providers can use to improve screening for the disorder. Though the relationship between BED and hemoglobin A1c control can vary, it appears that binge-eating behaviors can worsen metabolic markers, including glycemic control. Various medications used by patients with diabetes have been associated with new-onset BED, and treatment may be as simple as removing or replacing such agents. Several medications have been found to significantly reduce binge-eating frequency, and potentially, weight. Patients with BED generally benefit from psychotherapy, including cognitive behavioral therapy.
BED, only recently added to the International Classification of Disease-10 diagnostic list, is very common in patients with obesity and T2DM. The diagnosis is important to establish, as treatment or referral for treatment, could potentially improve many of the comorbidities and metrics of T2DM.
使医疗保健提供者熟悉暴饮暴食障碍（BED）的诊断和治疗，这是 2 型糖尿病（T2DM）的常见合并症。
对暴饮暴食和 T2DM 的文献进行综述。搜索中使用的关键词包括 BED、T2DM、肥胖症和治疗。
T2DM 患者中 BED 的患病率似乎远高于普通人群中 2%至 3.5%的患病率。研究表明，多达 20%的 T2DM 患者存在潜在的饮食障碍，其中最常见的是暴饮暴食。即使有多种简单的工具可以帮助医生改善对这种疾病的筛查，BED 也可能被漏诊。尽管 BED 与血红蛋白 A1c 控制之间的关系可能有所不同，但暴饮暴食行为似乎会恶化代谢标志物，包括血糖控制。糖尿病患者使用的各种药物与新发性 BED 有关，治疗方法可能很简单，只需去除或更换此类药物。一些药物已被发现可显著减少暴饮暴食的频率，并可能减轻体重。一般来说，患有 BED 的患者从心理治疗中受益，包括认知行为疗法。
BED 最近才被添加到国际疾病分类第 10 版的诊断列表中，但在肥胖和 T2DM 患者中非常常见。确定诊断很重要，因为治疗或转介治疗可能会改善 T2DM 的许多合并症和指标。
