Wing R R, Nowalk M P, Marcus M D, Koeske R, Finegold D
Diabetes Care. 1986 Mar-Apr;9(2):162-7. doi: 10.2337/diacare.9.2.162.
Several recent case reports have shown that anorexia nervosa and bulimia negatively affect glycemic control in diabetic patients. However, there have been no systematic studies to assess the prevalence of clinical or subclinical eating disorders among diabetic patients or to determine the impact of such disturbances on glycemic control. This study reports a survey of 202 adolescents, aged 12-18 yr, seen in the Diabetes Clinic, Children's Hospital of Pittsburgh, who were asked to complete the Binge Eating Scale (BES) and the EAT-26 questionnaire. Responses of diabetic patients to the EAT-26 questionnaire were compared with those of a nondiabetic control group and were related to measures of glycemic control. Diabetic subjects scored higher on the total EAT-26 than nondiabetic control subjects, ordinarily indicative of more eating pathology. However, diabetic subjects scored higher only on the dieting subscale of this questionnaire, probably reflecting adherence to the diabetes dietary regimen. Subjects with diabetes scored lower, or did not differ significantly, from nondiabetic control subjects on measures of oral control and bulimia. Among diabetic subjects, self-reported bulimic behaviors were related to poorer glycemic control. Patients with the highest scores on the BES had an average HbA1 of 13.1% compared with 11.8% for age- and sex-matched patients at the 50th percentile, and 10.8% for patients in the lowest 10th percentile. Further studies are needed to determine whether modification of these eating behaviors would improve glycemic control.
最近的几例病例报告显示，神经性厌食症和贪食症会对糖尿病患者的血糖控制产生负面影响。然而，尚无系统研究来评估糖尿病患者中临床或亚临床饮食失调的患病率，或确定此类紊乱对血糖控制的影响。本研究报告了一项对202名年龄在12至18岁的青少年进行的调查，这些青少年来自匹兹堡儿童医院糖尿病诊所，他们被要求完成暴饮暴食量表（BES）和EAT - 26问卷。将糖尿病患者对EAT - 26问卷的回答与非糖尿病对照组的回答进行比较，并与血糖控制指标相关联。糖尿病受试者在EAT - 26总分上的得分高于非糖尿病对照组受试者，这通常表明存在更多的饮食病理问题。然而，糖尿病受试者仅在该问卷的节食子量表上得分较高，这可能反映了他们对糖尿病饮食方案的遵守情况。在口腔控制和贪食症测量方面，糖尿病受试者的得分低于非糖尿病对照组受试者，或与非糖尿病对照组受试者无显著差异。在糖尿病受试者中，自我报告的贪食行为与较差的血糖控制有关。在BES上得分最高的患者，其平均糖化血红蛋白（HbA1）为13.1%，而年龄和性别匹配的第50百分位患者为11.8%，最低的第10百分位患者为10.8%。需要进一步研究来确定改变这些饮食行为是否会改善血糖控制。
