Thirty-eight female IDDM patients with recurrent binge eating episodes were divided into two groups according to the “Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition” (DSM-IV) criteria: IDDM patients with bulimia nervosa (DM + BN, n=23) and those with an “eating disorder not otherwise specified” (DM + NOS, n = 15). A number of psychological and medical variables were compared between these two groups and three control groups : IDDM patients without eating disorders (DM + ED(-)), non-diabetic patients with bulimia nervosa (BN), and women without diabetes and eating disorders (NORMAL). DM+BN showed the most severe psychopathology related to eating disorders, depressiveness, anxiety, highest HbA1C level, highest rate of diabetic retinopathy and neuropathy. On the other hand, DM + ED(-) had the least psychological and medical problems and DM + NOS was between DM + BN and DM + ED(-). Moreover, DM + BN manifested psychopathology as severely as BN, and DM + ED(-) as mildly as NORMAL. It may be useful to classify IDDM patients with binge eating behavior according to the diagnostic criteria of eating disorders in the DSM-IV criteria in order to identity the severity of their psychological and medical factors and to lead them to appropriate therapeutic interventions.
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