Insulin omission is the most common weight loss method after dieting among teenage girls with diabetes, according to the results of a Canadian study. In addition, eating disorders were found to be twice as common in adolescent females with diabetes as in their non-diabetic peers.
The study involved 361 participants with type 1 diabetes and 1,114 controls. All subjects were female and aged between 12 and 19. Dr Jennifer Jones (department of psychiatry, University health network, Toronto) and colleagues say that 11 per cent of the participants with diabetes reported that they were currently taking less than their prescribed dose of insulin in order to lose weight. Of the 36 subjects with diabetes who had an eating disorder, 42 per cent reported insulin misuse. In total, 10 per cent of the group with diabetes and 4 per cent of those without diabetes had an eating disorder.
Diabetic patients with an eating disorder had increased levels of glycosylated haemoglobin compared with those with diabetes alone. This indicated that they had impaired metabolic control, which would increase their risk of microvascular complications, the authors say. They add that it has been previously found that diabetic females with eating disorders have a three-fold increase in the risk of developing diabetic retinopathy.
The authors comment that further research is needed to assess whether intensive diabetes treatment regimens contribute to increased risk of eating disorders (British Medical Journal 2000;320:1563).