Article ; Online: Diabulimia and Type 1 Diabetes: An Unknown and Emerging Problem.
Endocrine, metabolic & immune disorders drug targets
2024
Abstract: Background: T1DM patients have a higher prevalence of eating disorders than the general population, and up to 30-40% of young T1DM patients suffer from an eating disorder, including diabulimia. Eating disorders worsen glycemic control and make insulin ... ...
Abstract | Background: T1DM patients have a higher prevalence of eating disorders than the general population, and up to 30-40% of young T1DM patients suffer from an eating disorder, including diabulimia. Eating disorders worsen glycemic control and make insulin therapy management more difficult. Closed loop systems (HCLS) allow major therapeutic flexibility; however, proper carbohydrate (CHO) counting remains a fundamental feature for insulin dose adjustments. Case report: A 30-year-old female patient affected by T1DM (with a past medical history of drug abuse and depressive syndrome) presented with inadequate glycemic control and prandial boli management. She started a CHO counting course and had a HCLS positioned, with progressive amelioration of glycemic control. During follow-up evaluations, HCLS data showed a progressive reduction and abeyance of prandial boli; the patient also developped an excessive fear of weight gain. An integrated approach between diabetologist, psychiatrist and dietitian allowed a diagnosis of diabulimia, an eating disorder characterized by a progressive reduction and elimination of carbohydrate ingestion and insulin boli, with episodes of uncontrolled binging and purging. A multidisciplinary approach (fortnightly dietetic and psychiatric evaluations, use of bioimpedance, fixed CHO content diet) allowed the patient to reach a better glycometabolic control and disease consciousness. Conclusion: T1DM patients need to pay great attention to food quality and quantity; hence, an eating disorder diagnosis may be challenging. Additionally, there are currently no standard screening methods for this purpose. In our experience, an integrated approach is fundamental and may be a valid strategy to face this emerging problem. |
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Language | English |
Publishing date | 2024-04-30 |
Publishing country | United Arab Emirates |
Document type | Journal Article |
ZDB-ID | 2228325-0 |
ISSN | 2212-3873 ; 1871-5303 |
ISSN (online) | 2212-3873 |
ISSN | 1871-5303 |
DOI | 10.2174/0118715303314948240419060714 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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