Although eating disorders are common in late adolescent diabetic patients, the occurrence in younger populations, particularly male diabetic patients, is not well documented (1,2). The prevalence was studied in 60 boys and 38 girls (13.78 ± 1.05 years of age, range 12–16) with diabetes duration 1.5 ± 3.35 years and in 321 boys and 254 girls as nondiabetic peers (13.73 ± 0.63 years of age, 12–16).
Patients and peers completed the Spanish validated version of the Eating Attitudes Test (EAT-40) (3). The semistructured Eating Disorder Examination (EDE) interview (4) was held for those with an EAT-40 >30 (13 diabetic patients and 57 nondiabetic peers) and an additional randomly selected population (24 diabetic patients and 57 nondiabetic peers) with an EAT-40 score <30. Eating disorders were classified as clinical (5) and subthreshold (1). SPSS version 9.0 was used for statistical analysis.
No cases of anorexia or bulimia were found. Eating disorders not otherwise specified (EDNOS) were more prevalent in diabetic patients than in peers: boys (1.7 vs. 0.9%, odds ratio 1.7, CI 95% 0.2–17.6) and girls (5.3 vs. 1.6%, 3.2, 0.62–17.2). Subthreshold eating disorders were more prevalent in male diabetic patients than in nondiabetic peers (10 vs. 4.4%, 2.4, 0.9–6.6), with no differences between female diabetic patients and nondiabetic peers (10.5 vs. 9.9%, 1.1, 0.4–3.2). Male diabetic patients had 2.4 times increased risk for subthreshold eating disorders than nondiabetic peers. No eating disorders were observed in the 24 diabetic patients and 57 nondiabetic peers with EAT-40 scores <30. Glycated hemoglobin values were higher in diabetic patients with eating disorders (9.8 ± 0.42 and 5.63 ± 2.76%, n = 13) than in those without (8.4 ± 1.5 and 5.09 ± 2.73%, n = 85) (P = 0.049).
Although no cases of anorexia or bulimia were found, EDNOS and subthreshold eating disorders were detected in younger diabetic patients of both sexes. The higher glycated hemoglobin levels found in diabetic patients with eating disorders suggest poor metabolic control and increased risk for later vascular complications (6). Further studies including large series of patients are necessary to confirm these preliminary results; however, our data underline the need for careful surveillance in young diabetic patients of both sexes in order to promptly detect and prevent these incipient eating disorders.