Differences between bulimia nervosa and binge-eating disorder in females with type 1 diabetes: The important role of insulin omission

This study explored the differences between bulimia nervosa ("BN," n=22) an d binge-eating disorder ("BED," n=11) in type 1 diabetic females and the fa ctors most predictive of poor glycemic control in patients suffering from t hese disorders. These two groups and a control group without eating disorde rs (n=32) were compared across a number of demographic, psychological, and medical variables. BN manifested significantly more severe disturbances rel ated to eating disorders, depression, anxiety, a higher rate of co-occurrin g mental disorders, and poorer psychosocial functioning compared with BED, BN also showed poorer glycemic control. Multivariate analysis indicated tha t higher serum glycosylated hemoglobin (HbA1c) levels were most associated with the presence of severe insulin omission in type 1 diabetic females wit h binge eating. Clinicians may be able to determine the psychological/medic al severity of illness in these patients by identifying the presence of com pensatory behaviors to prevent weight gain such as severe insulin omission, as described in the DSM-IV. (C) 1999 Elsevier Science Inc.