Eating disorders in adolescent females with and without type 1 diabetes: cross sectional studyBMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7249.1563 (Published 10 June 2000) Cite this as: BMJ 2000;320:1563
- Jennifer M Jones, research fellowa,
- Margaret L Lawson, headb,
- Denis Daneman, chiefc,
- Marion P Olmsted, directord,
- Gary Rodin, psychiatrist in chief ()e
- a Department of Psychiatry, University Health Network, Toronto, Ontario, Canada M5G 2CA
- b Division of Endocrinology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada K1H 8LI
- c Division of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada M5G 2CA
- d Ambulatory Care for Eating Disorders, University Health Network
- e Department of Psychiatry, University Health Network
- Correspondence to: G Rodin
- Accepted 24 February 2000
Objective: determine the prevalence of eating disorders in adolescent females with type 1 diabetes mellitus compared with that in their non-diabetic peers.
Design: Cross sectional case-control led study.
Setting: Diabetes clinics and schools in three Canadian cities.
Subjects: 356 females aged 12-19 with type 1 diabetes and 1098 age matched non-diabetic controls.
Main outcome measure: Eating disorders meeting Diagnostic and Statistical Manual of Mental Disorders(DSM-IV) criteria.
Results: Eating disorders that met DSM-IV criteria were more prevalent in diabetic subjects (36, 10%) than in non-diabetic controls (49, 4%) (odds ratio 2.4, 95% confidence interval 1.5 to 3.7; P<0.001). Subthreshold eating disorders were also more common in those with diabetes (49, 14%) than in controls (84, 8%) (odds ratio 1.9, 95% confidence interval 1.3 to 2.8; P<0.001). Mean haemoglobin A1cconcentration was higher in diabetic subjects with an eating disorder (9.4% (1.8)) than in those without (8.6% (1.6)), P=0.04).
Conclusions: DSM-IV and subthreshold eating disorders are almost twice as common in adolescent females with type 1 diabetes as in their non-diabetic peers. In diabetic subjects, eating disorders are associated with insulin omission for weight loss and impaired metabolic control.
Funding Medical Research Council of Canada (MA-12855), Children's Hospital of Eastern Ontario Research Institute (96/15S(E)), Genesis Foundation, and Toronto Hospital Psychiatry Research Fund.
Competing interests None declared.
The diagnostic criteria used for eating disorders are given on the BMJ's website