Insulin response to a rapid intravenous injection of dextrose in patients with anorexia nervosa and obesity

The secretion pattern of luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) was studied in 15 normal‐weight patients with bulimia over a 12‐hour period during the early follicular phase of the menstrual cycle. There were 12 agematched young women who served as controls. Mean 12‐hour FSH values were significantly decreased in bulimia; FSH peak height and frequency were not significantly different. Although bulimic patients as a group exhibited no significant changes in LH secretion, five patients showed decreased mean 12‐hour levels and a lower average LH peak.

Section: Discuss I 0 Nsupporting

confidence: 54%

Gonadotropin secretion pattern in bulimia nervosa

Pirke

Fichter²,

Schweiger

et al. 1987

“…Impaired glucose tolerance with overshooting insulin secretion has been reported in anorexia nervosa (Crisp et al, 1967; Schweiger et al, 1986), in starvation (Unger et al, 1963), and in low carbohydrate diets (Hales & Randle, 1963). Since impaired glucose tolerance is a further indicator of starvation and/ or carbohydrate restriction and possibly contributes to impairment of mechanisms of hunger and satiety, we examined insulin and glucose responses in bulimic patients.…”

mentioning

confidence: 99%

“…Pirke et al (1985) and Heufelder et al (1985) reported decreased triiodothyronine (TJ, decreased orthostatic norepinephrine response, increased betahydroxybutyric acid blood levels, and increased platelet alpha-2-adrenoceptor levels, which characterize hypometabolism and decreased sympathetic function. Impaired glucose tolerance with overshooting insulin secretion has been reported in anorexia nervosa (Crisp et al, 1967;Schweiger et al, 1986), in starvation (Unger et al, 1963), and in low carbohydrate diets (Hales & Randle, 1963). Since impaired glucose tolerance is a further indicator of starvation and/ or carbohydrate restriction and possibly contributes to impairment of mechanisms of hunger and satiety, we examined insulin and glucose responses in bulimic patients.…”

mentioning

confidence: 99%

Altered insulin response to a balanced test meal in bulimic patients

Schweiger

Poellinger²,

Laessle

et al. 1987

Impaired glucose tolerance with overshooting insulin secretion has been reported in anorexia nervosa, in starvation, and in low carbohydrate diets. Since impaired glucose tolerance is a further indicator of starvation andlor carbohydrate restriction and possibly contributes to impairment of mechanisms of hunger and satiety, we examined insulin and glucose responses in bulimic patients. Data show that in bulimic patients as compared with age‐matched controls, insulin secretion and glucose levels can be elevated after a balanced test meal. This indicates disturbed glucose tolerance. Whether this reduced glucose tolerance can be related to altered kinetics of insulin release or to cellular insulin resistance cannot be decided on the basis of our data.

“…It is postulated that intermittent starvation and its relief through binge eating instigates a self-perpetuating hyperinsulinemic reponse as a metabolic defense. Support for this hypothesis is provided by the findings in bulimic patients of Schweiger et al (1987) and the early work of Unger et al (1963) in experimental starvation and Crisp et al (1967) and Kalucy et al (1976) in patients with anorexia nervosa. Furthermore, stress reduction through carbohydrate ingestion in the chronically intermittently starved individual might be reflected in a greater reduction in cortisol than a situation of normal nutrition.…”

Section: Discussionmentioning

confidence: 89%

Insulin, glucose, and cortisol levels in bulimia: Effect of treatment

Russell

Hooper²,

Storlien

et al. 1989

A study is described in which a modified glucose tolerance test was performed in each of five bulimic female patients on two separate occasions. Two of the patients were poorly controlled outpatients and three were inpatients in a strict hospital program of nutritional rehabilitation and psychotherapy. Plasma glucose, insulin, and cortisol levels, in response to a glucose load and following 3 days of normal nutrition, were compared with those documented following engagement in various bulimic behaviors during the preceding 24 hours (i.e., fasting, binging, and vomiting.). In all five patients, following bulimic behaviors, peak insulin levels in response to a glucose load and the area under the curve of insulin secretion was increased whereas cortisol levels were lower, even in the one patient who was hypercortisolemic. However, the insulin peaks were less in evidence in the treated patients than in those who continued to engage in bulimic behavior, and there was also less evidence of cortisol suppression in the treated patients. Furthermore, insulin secretion as measured by T , , , occurred more rapidly after engagement in bulimic behavior and was delayed in treated patients following normal nutrition. lt is postulated that insulin potentiation and suppression of stress hormones as reflected by serum cortisol are important self-perpetuating mechanisms in bulimia and that these are related to the occurrence of intermittent starvation and its relief through binge eating. Treatment reduces this effect by reestablishing regular nutrition.Self-induced starvation is an important component of both anorexia nervosa and bulimia (Pirke et al., 1985) where binge eating has been said to represent