Herpertz S, Albus C, Wagener R, Kocnar M, Wagner R, Henning A, Best F, Foerster H, Schulze Schleppinghoff B, Thomas W, Köhle K, Mann K, Senf W
Clinic of Psychotherapy and Psychosomatics, University of Essen, Germany.
Diabetes Care. 1998 Jul;21(7):1110-6. doi: 10.2337/diacare.21.7.1110.
This multicenter study was designed to explore the prevalence of clinical and subclinical eating disorders (EDs), the extent of intentional omission of insulin and oral antidiabetic agents, and its relationship to glycemic control in an inpatient and outpatient population of men and women with type 1 and type 2 diabetes.
Data have been collected from 12 diabetes medical centers in two German cities. In a questionnaire and interview-based study, a sample of male and female patients (n = 341 type 1, n = 322 type 2) was assessed for the following eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. For lack of interview data of several patients meeting the screening criteria, prevalence ranges were calculated.
The overall prevalence range of current EDs was 5.9-8.0% (lifetime prevalence 10.3-14.0%). When patients were stratified according to type 1 and type 2 diabetes, there was no difference in prevalence of EDs. However, the distribution of the EDs was different in both types of diabetes, with a predominance of binge eating disorder in the type 2 diabetes sample. Type 1 (5.9%) and type 2 (2.2%) diabetic patients reported deliberate omission of hyperglycemic drugs (insulin or oral agents) in order to lose weight. Compared with control subjects, neither the presence of EDs nor insulin omission influenced diabetic control.
There seems to be no difference in prevalence rates of EDs in both types of diabetes; however, distribution of EDs is different. The findings suggest that neither EDs nor insulin omission are necessarily associated with poor control of glycemia. Binge eating disorder seems to precede type 2 diabetes in most patients and could be one of the causes of obesity that often precedes type 2 diabetes.
本多中心研究旨在探讨临床和亚临床饮食失调（EDs）在1型和2型糖尿病住院及门诊男女患者中的患病率、故意漏用胰岛素和口服抗糖尿病药物的程度及其与血糖控制的关系。
数据收集自德国两个城市的12个糖尿病医疗中心。在一项基于问卷和访谈的研究中，对一组男性和女性患者（1型糖尿病患者341例，2型糖尿病患者322例）进行了以下饮食失调评估：神经性厌食症、神经性贪食症、暴饮暴食症和未另行规定的饮食失调症。由于部分符合筛查标准的患者缺乏访谈数据，因此计算了患病率范围。
当前饮食失调症的总体患病率范围为5.9%-8.0%（终生患病率为10.3%-14.0%）。当患者按1型和2型糖尿病分层时，饮食失调症的患病率没有差异。然而，两种类型糖尿病中饮食失调症的分布不同，2型糖尿病样本中以暴饮暴食症为主。1型（5.9%）和2型（2.2%）糖尿病患者报告为了减肥故意漏用降糖药物（胰岛素或口服药物）。与对照组相比，饮食失调症的存在和胰岛素漏用均未影响糖尿病控制。
两种类型糖尿病中饮食失调症的患病率似乎没有差异；然而，饮食失调症的分布不同。研究结果表明，饮食失调症和胰岛素漏用不一定与血糖控制不佳相关。在大多数患者中，暴饮暴食症似乎先于2型糖尿病出现，可能是2型糖尿病常见的肥胖原因之一。
