medwireNews: Children and young adults with type 1 diabetes are more likely to be diagnosed with an eating disorder than their diabetes-free peers but are less likely to receive outpatient treatment for their condition, Finnish research shows.
Leon Hirvelä and colleagues, from the University of Helsinki, say their data “emphasise the need for targeted eating disorder treatment for people with type 1 diabetes.”
The study included 11,055 individuals younger than 30 years old (mean age 14.1 years, 47.5% female) who were diagnosed with type 1 diabetes between 1998 and 2010, and the same number of diabetes-free control individuals who were matched for age, sex, and hospital district.
The researchers report in Diabetologia that, during a mean 13.1 years of follow-up, the incidence of hospital-treated eating disorders, such as anorexia nervosa, bulimia nervosa, and overeating or vomiting associated with other psychological disturbances, was a significant 2.35 times higher among individuals with type 1 diabetes than among the control individuals, after adjustment for age, sex, socioeconomic status, and place of residence.
Specifically, there were 175 cases of eating disorders recorded among the participants with type 1 diabetes and 75 cases recorded in those without diabetes, corresponding to incidence rates of 121.5 and 51.5 cases per 100,000 person–years.
Hirvelä and team found that a “substantial” proportion (61.6%) of the 250 individuals with an eating disorder were given newly prescribed psychotropic medications, namely antipsychotics, antidepressants, and anxiolytics, but the prescribing rate did not differ significantly between the people with and without diabetes, at 183.4 and 196.8 per 1000 person–years, respectively.
There was also no significant difference between the two groups in the mean number of inpatient care days per year, at 2.41 for people with diabetes and 3.69 for those without diabetes.
However, the mean number of outpatient care visits per year was significantly lower among the individuals with type 1 diabetes relative to those without diabetes, at 3.32 versus 5.33.
This indicates “that eating disorders in patients with type 1 diabetes are undertreated relative to those without diabetes,” a finding that is “in line with previous small, single-centred studies,” the authors remark.
They describe the treatment discrepancy as “concerning, as eating disorders are associated with increased morbidity and mortality rates among type 1 diabetes patients,” and therefore suggest that “eating disorders among people with type 1 diabetes should be treated more intensively, not less intensively, than eating disorders in general.”
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