{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:54:17Z","timestamp":1790610857899,"version":"4.1.0"},"reference-count":39,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":2667,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,6,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To compare clinical characteristics and outcome of type 1 diabetes mellitus (T1DM) between patients with and without a clinically recognized eating disorder (ED).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESEARCH DESIGN AND METHODS<\/jats:title><jats:p>A total of 52,215 T1DM patients aged 8 to &amp;lt;30 years from the prospective diabetes data acquisition system DPV were analyzed. A total of 467 patients had an additional diagnosis of ED according to DSM-IV criteria (anorexia nervosa [AN], n = 141 [female: 94.3%]; bulimia nervosa [BN], n = 62 [90.3%]; and EDs not otherwise specified, including binge-eating disorder [EDNOS], n = 264 [74.2%]). Groups were compared using multivariable regression. Cox proportional hazard ratios were calculated for the association between ED and retinopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After adjustment for age, sex, and duration of diabetes, patients with ED revealed higher HbA1c (no ED vs. AN, BN, or EDNOS, respectively: 8.29 \u00b1 0.01% [67.1 \u00b1 0.1 mmol\/mol] vs. 8.61 \u00b1 0.15% [70.6 \u00b1 1.6 mmol\/mol], 9.11 \u00b1 0.23% [76.1 \u00b1 2.5 mmol\/mol], or 9.00 \u00b1 0.11% [74.9 \u00b1 1.2 mmol\/mol]) and a higher rate of pathological insulin injection sites (48.4 vs. 64.3, 64.1, or 62.1%). Furthermore, ketoacidosis (5.7 \u00b1 0.1 vs. 12.1 \u00b1 2.1, 18.0 \u00b1 4.1, or 12.9 \u00b1 1.6 events per 100 person-years) and hospitalization (54.9 \u00b1 0.3 vs. 89.3 \u00b1 6.0, 132.0 \u00b1 12.7, or 91.0 \u00b1 4.4 per 100 person-years) were more common, and duration of hospital stay was longer (4.81 \u00b1 0.01 vs. 11.31 \u00b1 0.21, 18.05 \u00b1 0.48, or 8.44 \u00b1 0.13 days per year). All P values were &amp;lt;0.05. Patients with BN and EDNOS had a 2.5-fold (95% CI 1.3\u20134.8) and a 1.4-fold (0.8\u20132.3) higher risk for retinopathy, whereas AN patients had no increased risk (0.9 [95% CI 0.4\u20132.3]).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Diabetes health care professionals should be aware of comorbid EDs in pediatric\/young-adult T1DM patients. An ED diagnosis is associated with worse metabolic control and higher rates of diabetes complications.<\/jats:p><\/jats:sec>","DOI":"10.2337\/dc13-2156","type":"journal-article","created":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T01:46:07Z","timestamp":1394675167000},"page":"1581-1589","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":93,"title":["Clinical Characteristics and Outcome of 467 Patients With a Clinically Recognized Eating Disorder Identified Among 52,215 Patients With Type 1 Diabetes: A Multicenter German\/Austrian Study"],"prefix":"10.2337","volume":"37","author":[{"given":"Nicole","family":"Scheuing","sequence":"first","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Bartus","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Olgahospital Stuttgart, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Haberland","sequence":"additional","affiliation":[{"name":"Hospital for Children and Adolescents, Sana Hospital Berlin Lindenhof, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Icks","sequence":"additional","affiliation":[{"name":"Department of Public Health, Heinrich-Heine University D\u00fcsseldorf, D\u00fcsseldorf, Germany"},{"name":"Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhild","family":"Knauth","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Christian Association of Youth Villages Berchtesgaden Health-Education-Employment, Berchtesgaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Nellen-Hellmuth","sequence":"additional","affiliation":[{"name":"Diabetes Centre Mergentheim, Bad Mergentheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Rosenbauer","sequence":"additional","affiliation":[{"name":"Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center at University of D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Teufel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Psychosomatic 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