Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes.

Bryden, Kathryn S.; Neil, Andrew; Mayou, Richard; Peveler, Robert; Fairburn, C G; Dunger, David B.

doi:10.2337/diacare.22.12.1956

Cited by 280 publications

(206 citation statements)

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“…This, in turn, may impair treatment adherence and impede therapy intensification, with consequent failure to achieve glycaemic goals 1, 2. Weight gain is associated with an increased risk of coronary heart and cardiovascular disease in people with diabetes 3, 4, a troubling prospect given that 80–90% of people with T2D are already overweight before insulin replacement 5.…”

Section: Introductionmentioning

confidence: 99%

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Russell‐Jones

Danne

Hermansen

et al. 2015

Diabetes Obesity Metabolism

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Insulin therapy is often associated with adverse weight gain. This is attributable, at least in part, to changes in energy balance and insulin's anabolic effects. Adverse weight gain increases the risk of poor macrovascular outcomes in people with diabetes and should therefore be mitigated if possible. Clinical studies have shown that insulin detemir, a basal insulin analogue, exerts a unique weight‐sparing effect compared with other basal insulins. To understand this property, several hypotheses have been proposed. These explore the interplay of efferent and afferent signals between the muscles, brain, liver, renal and adipose tissues in response to insulin detemir and comparator basal insulins. The following models have been proposed: insulin detemir may reduce food intake through direct or indirect effects on the central nervous system (CNS); it may have favourable actions on hepatic glucose metabolism through a selective effect on the liver, or it may influence fluid homeostasis through renal effects. Studies have consistently shown that insulin detemir reduces energy intake, and moreover, it is clear that this shift in energy balance is not a consequence of reduced hypoglycaemia. CNS effects may be mediated by direct action, by indirect stimulation by peripheral mediators and/or via a more physiological counter‐regulatory response to insulin through restoration of the hepatic–peripheral insulin gradient. Although the precise mechanism remains unclear, it is likely that the weight‐sparing effect of insulin detemir can be explained by a combination of mechanisms. The evidence for each hypothesis is considered in this review.

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Section: Introductionmentioning

confidence: 99%

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Russell‐Jones

Danne

Hermansen

et al. 2015

Diabetes Obesity Metabolism

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“…Rydall et al (8) found that DEB at the study baseline among a cohort of adolescent girls with type 1 diabetes predicted a tripled risk of retinopathy 4 years later. In a third study, Bryden et al (13) assessed a group of individuals with type 1 diabetes in adolescence and then again in early adulthood. They found that rates of overweight, concern over weight and shape, and heightened dietary restraint all increased from adolescence to adulthood.…”

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confidence: 99%

Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence

et al. 2015

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OBJECTIVEGirls and women with type 1 diabetes are at increased risk for developing eating disorders (EDs), and these disorders are associated with serious diabetes-related medical complications. This study describes the longitudinal course of disturbed eating behavior (DEB) and EDs in a cohort with type 1 diabetes. RESEARCH DESIGN AND METHODSA total of 126 girls with type 1 diabetes receiving care for diabetes at The Hospital for Sick Children in Toronto participated in a series of seven interview-based assessments of ED behavior and psychopathology over a 14-year period, beginning in late childhood. Survival analysis was used. RESULTSMean age was 11.8 6 1.5 years at time 1 and 23.7 6 2.1 years at time 7. At time 7, 32.4% (23/71) met the criteria for a current ED, and an additional 8.5% (6/71) had a subthreshold ED. Mean age at ED onset (full syndrome or below the threshold) was 22.6 years (95% CI 21.6-23.5), and the cumulative probability of onset was 60% by age 25 years. The average time between onset of ED and subsequent ED remission was 4.3 years (95% CI 3.1-5.5), and the cumulative probability of remission was 79% by 6 years after onset. The average time between remission of ED and subsequent recurrence was 6.5 years (95% CI 4.4-8.6), and the cumulative probability of recurrence was 53% by 6 years after remission. CONCLUSIONSIn this longitudinal study, EDs were common and persistent, and new onset of ED was documented well into adulthood. Further research regarding prevention and treatment for this vulnerable group is urgently needed.The prevalence, clinical characteristics, and medical consequences of disturbed eating behavior (DEB) and eating disorders (EDs) in individuals with type 1 diabetes has received increasing attention since case reports of this dangerous combination were first published in the 1980s (1,2). Although the specificity of this association was initially unclear, systematic research has demonstrated that teenage girls and women with type 1 diabetes are at significantly increased risk of DEB compared with their nondiabetic peers (3). Such DEB includes dieting, fasting, binge-eating, and a range of compensatory and purging behaviors that can directly interfere with optimal diabetes management. A slide set summarizing this article is available online.

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“…[24][25][26] Observando as diretrizes diagnósticas da CID 10 para BN, o item B descreve comportamentos para compensar as conseqüências da ingestão alimentar altamente calórica e faz uma referência a pacientes diabéti-cos: "quando a bulimia ocorre em pacientes diabéticos, eles podem escolher negligenciar seu tratamento insulínico". Herpertz et al 12 mostraram, numa amostra de 663 pacientes diabéticos dos tipos 1 e 2, a prevalência em comorbidade e distribuição dos três principais TA: a anorexia nervosa, a bulimia nervosa e o transtorno da compulsão alimentar periódica.…”

Section: 5-10unclassified

Diabetes e transtornos alimentares: uma associação de alto risco

Azevedo

Papelbaum

D’Elia

2002

Rev. Bras. Psiquiatr.

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Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes.

Cited by 280 publications

References 0 publications

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?

Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence

Diabetes e transtornos alimentares: uma associação de alto risco

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