Disordered eating behaviors in type 1 diabetic patients
Disordered eating behaviors in type 1 diabetic patients
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DOI：
10.4239/wjd.v2.i11.189
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发表时间：
2011-11-15
影响因子：
4.2
通讯作者：
Garcia-Mayor, Ricardo V.
中科院分区：
文献类型：
--
作者：
Larranaga, Alejandra;Docet, Maria F.;Garcia-Mayor, Ricardo V.
1 型糖尿病患者饮食行为失调 (DEB) 的风险很高。由于1型糖尿病是儿童和青少年最常见的慢性疾病之一，饮食失调（ED）和糖尿病的共存经常影响青少年和年轻人。由于在这种发育状态下体重管理对于 1 型糖尿病患者来说尤其困难，因此一些糖尿病患者可能会限制或省略胰岛素（一种称为饮食失调症的病症）作为体重控制的一种形式。已经清楚地表明，1 型糖尿病患者的 ED 与代谢控制受损、酮症酸中毒发作更频繁以及糖尿病相关微血管并发症（特别是视网膜病变）的发病早于预期有关。这些病症的管理需要一个由内分泌学家/糖尿病学家、护士教育家、营养师、心理学家，通常还包括精神病学家组成的多学科团队。 1型糖尿病合并DEB和ED的治疗应由以下组成部分：糖尿病治疗、营养管理和心理治疗。在糖尿病治疗的初始阶段，建议高度怀疑饮食失调的存在，特别是那些代谢控制持续不佳、酮症酸中毒反复发作和/或体重和体形问题的患者，尤其是年轻女性。考虑到该问题的严重程度以及与之相关的严重医疗风险，旨在改善其治疗的更多临床和技术研究对于这一高危人群的未来健康至关重要。 (C)2011年百事登。版权所有。
Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population. (C) 2011 Baishideng. All rights reserved.