Does binge-eating matter for glycemic control in type 2 diabetes patients?
Does binge-eating matter for glycemic control in type 2 diabetes patients?
复制标题
暴食对 2 型糖尿病患者的血糖控制有影响吗？
DOI：
10.1186/s40337-019-0260-4
复制
发表时间：
2019
影响因子：
4.1
通讯作者：
J. C. Appolinario
中科院分区：
文献类型：
--
作者：
M. Papelbaum;Rodrigo de Oliveira Moreira;W. Coutinho;R. Kupfer;S. Freitas;Ronir Raggio Luz;J. C. Appolinario
饮食行为是与 2 型糖尿病 (T2DM) 治疗相关的一个重要方面，可能对血糖控制产生影响。此前的报告显示，2 型糖尿病患者的临床样本中饮食失调行为的患病率升高，尤其是暴食症。然而，关于饮食失调对 T2DM 血糖和临床控制影响的结果并不一致。本研究的目的是评估共病饮食失调对一组 T2DM 患者血糖控制 (GC) 的影响。使用 DSM-IV 结构化临床访谈和暴食量表对 70 名连续 T2DM 患者的饮食行为进行了评估。通过空腹血糖 (FBG) 和糖化血红蛋白 (A1c) 水平检查 GC。此外，还评估了次要临床变量，包括体重指数（BMI）和血脂。使用卡方和学生 T 检验来比较患有和不患有 ED 的患者的临床和精神病理特征。为了评估 GC 和饮食失调 (ED) 之间的关系，进行了线性回归分析，并控制了 BMI。采用 5% 的显着性水平。 77% 的样本 (n = 54) 是女性，50% 是肥胖者。 14 名患者表现出 ED，其中大部分是暴食症 (BED)。在回归分析中，FBG（β系数 = 47.4（22.3）；p = 0.037）和A1c（β系数 = 1.12（0.57）；p = 0.05）均通过ED的存在进行预测。然而，在模型中添加 BMI 后，ED 的存在就失去了对血糖控制结果的影响。在 T2DM 患者中经常观察到饮食精神病理学现象。在 T2DM 患者中，合并 ED 与 BMI 较高时血糖控制较差有关。 T2DM 患者饮食失调行为的存在似乎与糖尿病患者的常规护理具有临床相关性。因此，我们建议对 T2DM 患者进行饮食精神病理学评估。
Eating behavior is an important aspect related to type 2 diabetes mellitus (T2DM) treatment and may have an impact on glycemic control. Previous reports showed elevated prevalence of eating disordered behaviors, especially binge eating disorder in clinical samples of type 2 diabetes patients. However, results regarding the impact of an eating disorder on the glycemic and clinical control of T2DM is inconsistent. The purpose of this study was to assess the impact of a comorbid eating disorder on glycemic control (GC) in a group of patients with T2DM. Eating behaviors of 70 consecutive patients with T2DM were assessed using a Structured Clinical Interview for DSM-IV and the Binge Eating Scale. The GC was examined with fasting blood glucose (FBG) and glycated hemoglobin (A1c) levels. In addition, secondary clinical variables were assessed, including body mass index (BMI) and lipids. Chi-square and Student’s T tests were used to compare clinical and psychopathological characteristics of patients with and without an ED. In order to evaluate the relationship between GC and eating disorder (ED) a linear regression analysis was performed, controlling for BMI. A significance level of 5% was adopted. Seventy-seven percent of the sample (n = 54) were female and 50% were obese. Fourteen patients exhibited an ED, mostly binge eating disorder (BED). In a regression analysis, both FBG (beta coefficient = 47.4 (22.3); p = 0.037) and A1c (beta coefficient = 1.12 (0.57); p = 0.05) were predicted by the presence of an ED. However, the presence of an ED lost its impact on glycemic control outcomes after the addition of the BMI in the models. Eating psychopathology is frequently observed in patients with T2DM. Among individuals with T2DM, co-morbid ED is associated with a poorer glycemic control in the presence of a higher BMI. The presence of an eating disordered behavior in patients with T2DM seems to have clinical relevance in the usual care of patients with diabetes. Therefore, we recommend eating psychopathology should be routinely assessed in T2DM patients.