WOMEN WITH INSULIN-DEPENDENT DIABETES-MELLITUS (IDDM) COMPLICATED BY EATING DISORDERS ARE AT RISK FOR EXACERBATED ALTERATIONS IN LIPID-METABOLISM

Objective: To examine lipid parameters that are affected in women with insulin-dependent diabetes mellitus (IDDM) who engaged in disordered eating behaviours. Design: Randomized, unmatched. Setting: Tertiary ca re. Subjects: Ninety women (18-46 y) with IDDM. Interventions: Classif ication of subjects based on severity of eating disorder: clinical (n= 14), subclinical (n=13) and control (n=63). Blood was analysed for gly cosylated haemoglobin (HbA(1c)) and serum for triglycerides and choles terol. Carotenoid and tocopherol concentrations were analysed by high performance liquid chromatography (HPLC). Dietary intake was assessed by the National Cancer Institute food frequency questionnaire. Results : HbA(1c) was significantly increased im women demonstrating clinical and subclinical symptoms compared to control (10.4+/-2.6, 10.0+/-1.5 a nd 8.3+/-1.6%, respectively, P<0.05). Triglyceride concentrations were significantly increased in women with subclinical eating disorders co mpared to controls. In women who intentionally omitted or reduced insu lin, triglyceride cholesterol and HbA(1c) were significantly increased compared to controls. Women with IDDM and eating disorders who exhibi ted bulimic behaviours consumed significantly more energy, total fat a nd cholesterol compared to controls and women with eating disorders wh o were restrained eaters. Conclusion: While IDDM is known to perturb l ipid metabolism, these data demonstrate that eating disorders, in comb ination with IDDM, results in additional alterations in lipid metaboli sm.