Predictors of diabetic long-term complications in type 1 diabetic females with recurrent binge eating

饮食失调和1型糖尿病的同时发生会导致糖尿病微血管并发症的提前发生。然而，进食障碍的哪些特征特别导致并发症尚不清楚。我们试图确定1型糖尿病女性患者临床饮食失调的视网膜病变和肾病的预测因素。受试者为109名1型糖尿病女性，经DSM-IV结构化临床访谈诊断为临床进食障碍;神经性贪食症（n=70）、暴食症（n=28）、神经性厌食症（n=7）和未另行说明的进食障碍（n=4）。筛查视网膜病变、晚期视网膜病变（增殖前和增殖性视网膜病变）和肾病，并调查人口统计学、医学和心理/行为因素，包括与进食障碍相关的各种问题行为的持续时间。为了确定每种并发症的预测因素，进行logistic回归分析。在与临床饮食失调的1型糖尿病女性患者的饮食失调相关的各种问题行为因素中，严重胰岛素遗漏是视网膜病变、晚期视网膜病变和肾病的最重要预测因素。此外，正如一般糖尿病报告的那样，糖尿病的持续时间是这些并发症的另一个预测因素。在管理1型糖尿病女性患者的临床进食障碍时，临床医生应将重点放在让患者正确使用胰岛素上，以预防并发症。

Concurrence of eating disorders and type 1 diabetes leads to an earlier development of diabetic microvascular complications. However, what features of eating disorders specifically lead to complications are unknown. We sought to determine the predictors of retinopathy and nephropathy in type 1 diabetic females with clinical eating disorders. Subjects were 109 type 1 diabetic females with clinical eating disorders diagnosed by the Structured Clinical Interview for DSM-IV ; bulimia nervosa (n=70), binge-eating disorder (n=28), anorexia nervosa (n=7), and eating disorder not otherwise specified (n=4). Retinopathy, advanced retinopathy (preproliferative and proliferative retinopathy), and nephropathy were screened and demographic, medical, and psychological/behavioral factors including the duration of various problematic behaviors related to eating disorders were investigated. To identify the predictors of each complication, logistic regression analysis was done. Of the various problematic behavioral factors related to eating disorders of type 1 diabetic females with clinical eating disorders, severe insulin omission was the most important predictor of retinopathy, advanced retinopathy, and nephropathy. Moreover, as has been reported for diabetes in general, the duration of diabetes was another predictor of these complications. In their management of type 1 diabetic females with clinical eating disorders, clinicians should focus their effort to prevent complications on having patients properly administer insulin.