Yomna E. Dean, Karam R. Motawea, Muaaz Aslam, Jose J. Loayza Pintado, Helen A. O. Popoola-Samuel, Mohamed Salam, Prashant Obed Reddy Dundi, Webster Donaldy, Esraa M. Aledani, Zaineh Alqiqie, Nazia Sultana, Alaa Ramadan Hussein Mohamed, Amir Elalem, Sidra Tahreem Hashmi Syeda, Mai Saad Mohamed, Mazen W. Assal, Nada M. Attia, Hanan Hagar, Heba Ahmed Abdelaziz, Anuj Subedi, Areeg Elbahaie, Yusef Hazimeh, Hani Aiash
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Our paper aimed to analyse different EDs and disordered eating behaviours that may be practiced by patients with T1DM.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A literature search of PubMed, Scopus and Web of Science was conducted on 17 January 2023, using the key terms “T1DM,” “Eating Disorders” and “Bulimia.” Only observational controlled studies were included. The Revman software (version 5.4) was used for the analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>T1DM was associated with increased risk of ED compared with nondiabetic individuals (RR = 2.47, 95% CI = 1.84–3.32, <i>p</i>-value < 0.00001), especially bulimia nervosa (RR = 2.80, 95% CI = 1.18–6.65, <i>p</i>-value = 0.02) and binge eating (RR = 1.53, 95% CI = 1.18–1.98, <i>p</i>-value = 0.001). 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引用次数: 0
摘要
背景 以往的荟萃分析表明，饮食失调（ED）与 1 型糖尿病（T1DM）之间的关联结果不一。本文旨在分析 T1DM 患者可能存在的不同 ED 和饮食失调行为。 方法 2023 年 1 月 17 日，我们使用关键字 "T1DM"、"进食障碍 "和 "贪食症 "对 PubMed、Scopus 和 Web of Science 进行了文献检索。仅纳入了观察性对照研究。分析使用 Revman 软件（5.4 版）。 结果 与非糖尿病患者相比，T1DM 与发生 ED 的风险增加有关（RR = 2.47，95% CI = 1.84-3.32，p 值 = 0.00001），尤其是神经性贪食症（RR = 2.80，95% CI = 1.18-6.65，p 值 = 0.02）和暴食症（RR = 1.53，95% CI = 1.18-1.98，p 值 = 0.001）。我们的分析表明，无论采用哪种问卷诊断 ED，T1DM 患者的 ED 风险都会增加；DM 验证问卷（RR = 2.80，95% CI = 1.91-4.12，p 值 = 0.00001）和普通问卷（RR = 2.03，95% CI = 1.27-3.23，p 值 = 0.003）。胰岛素漏用/滥用的发生率为 10.3%；女性糖尿病患者漏用和滥用胰岛素的风险明显高于男性糖尿病患者。 结论 我们的研究证实，ED 与 T1DM，尤其是暴食症和暴饮暴食与 T1DM 之间存在明显的联系。此外，女性糖尿病患者滥用/漏用胰岛素的风险更高。早期主动筛查至关重要，而且要量体裁衣；建议对这一人群进行糖尿病和 ED 综合干预，并转介给专门的精神科医生。
Association Between Type 1 Diabetes Mellitus and Eating Disorders: A Systematic Review and Meta-Analysis
Background
Previous meta-analyses have shown mixed results regarding the association between eating disorders (EDs) and type 1 diabetes mellitus (T1DM). Our paper aimed to analyse different EDs and disordered eating behaviours that may be practiced by patients with T1DM.
Methods
A literature search of PubMed, Scopus and Web of Science was conducted on 17 January 2023, using the key terms “T1DM,” “Eating Disorders” and “Bulimia.” Only observational controlled studies were included. The Revman software (version 5.4) was used for the analysis.
Results
T1DM was associated with increased risk of ED compared with nondiabetic individuals (RR = 2.47, 95% CI = 1.84–3.32, p-value < 0.00001), especially bulimia nervosa (RR = 2.80, 95% CI = 1.18–6.65, p-value = 0.02) and binge eating (RR = 1.53, 95% CI = 1.18–1.98, p-value = 0.001). Our analysis has shown that increased risk of ED among T1DM persisted regardless of the questionnaire used to diagnose ED; DM-validated questionnaires (RR = 2.80, 95% CI = 1.91–4.12, p-value < 0.00001) and generic questionnaires (RR = 2.03, 95% CI = 1.27–3.23, p-value = 0.003). Prevalence of insulin omission/misuse was 10.3%; diabetic females demonstrated a significantly higher risk of insulin omission and insulin misuse than diabetic males.
Conclusion
Our study establishes a significant and clear connection between EDs and T1DM, particularly bulimia and binge eating, with T1DM. Moreover, female diabetics are at higher risk of insulin misuse/omission. Early proactive screening is essential and tailored; comprehensive interventions combining diabetes and ED components are recommended for this population, with referral to a specialised psychiatrist.
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