OBJECTIVE - To characterize the relationship of subclinical and clinic
al eating disorders to HbA(1c) values in women with IDDM. RESEARCH DES
IGN AND METHODS - Ninety women with IDDM (18-46 years of age) were rec
ruited from diabetes clinics throughout Connecticut and Massachusetts.
Subjects were categorized into one of three groups according to the D
iagnostic Statistical Manual of Mental Disorders (DSM-III-R) criteria
for eating disorders as Follows: the clinical group (n = 14), the subc
linical group (partially fulfilling the diagnostic criteria; n = 13),
and the control group (n = 63). Group differences in the degree of die
tary restraint, binge eating, and bulimic behaviors and weight, shape,
and eating concerns were assessed with the Eating Disorder Examinatio
n (EDE) and the Bulimia Test Revised (BULIT-R). RESULTS - Women with s
ubclinical and clinical eating disorders had clinically elevated HbA(1
c) results and more diabetes-related complications, compared with the
control subjects, The severity of bulimic behaviors, weight concerns,
reduced BMI, and decreased frequency of blood glucose monitoring were
associated with elevated HbA(1c). CONCLUSIONS - HbA(1c) may have clini
cal utility in the identification of eating disorder behavior in femal
es with IDDM. Health care professionals should be aware of the potent
effect of subclinical and clinical eating behaviors including insulin
misuse in weight-conscious women with IDDM who have poor glycemic cont
rol.