{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:04:56Z","timestamp":1785326696345,"version":"3.55.0"},"reference-count":16,"publisher":"American Diabetes Association","issue":"9","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2002,9,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To classify type 1 diabetic females with bulimia nervosa (BN) by type of inappropriate compensatory behavior in order to prevent weight gain (ICB) and to investigate the group differences.<\/jats:p>\n               <jats:p>RESEACH DESIGN AND METHODS\u2014Type 1 diabetic females with BN, diagnosed by structured diagnostic interview based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) criteria, were classified by type of ICB as follows: 1) only severe insulin omission as an ICB (BN-I) (n = 22), 2) both severe insulin omission and self-induced vomiting and\/or laxative abuse (BN-IP) (n = 22), or 3) no insulin omission but another ICB (BN-NI) (n = 11). The clinical characteristics of these three groups and a binge-eating disorder (BED) group (n = 24) were compared.<\/jats:p>\n               <jats:p>RESULTS\u2014The BN-IP and BN-I groups had the highest HbA1c levels. The BN-IP group had the highest rates of diabetic neuropathy, retinopathy, and nephropathy. The BN-NI group had the second highest rates of neuropathy and retinopathy. The BN-IP group had the highest frequencies of diabetes- and ketoacidosis-related hospital admissions, and the BN-I group had the second highest frequencies. The BN-NI group showed the highest scores on psychological tests related to depression, anxiety, eating disorder psychopathology, and perfectionism. The BN-NI group had the highest rate of history of visits to a psychiatrist, and the BN-IP group had the second highest history.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Type 1 diabetic females with BN seem not to be homogenous and can be classified into three distinctive subgroups by type of ICB. Individuals with BN-IP had the most severe problems with both medical and psychological\/behavioral aspects. Individuals with BN-NI manifested the highest psychological distress. The BN-I group had comparatively mild distress despite having the poorest metabolic control. Each BN group manifested more severe pathology than the BED group.<\/jats:p>","DOI":"10.2337\/diacare.25.9.1571","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"1571-1575","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":25,"title":["Classification of Type 1 Diabetic Females With Bulimia Nervosa Into Subgroups According to Purging Behavior"],"prefix":"10.2337","volume":"25","author":[{"given":"Masato","family":"Takii","sequence":"first","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medicine, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuko","family":"Uchigata","sequence":"additional","affiliation":[{"name":"Diabetes Center, Tokyo Women\u2019s Medical University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Nozaki","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medicine, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nishikata","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medicine, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medicine, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Komaki","sequence":"additional","affiliation":[{"name":"Division of Psychosomatic Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Diabetes Center, Tokyo Women\u2019s Medical University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiharu","family":"Kubok","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine, Graduate School of Medicine, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031214442194900_R1","doi-asserted-by":"crossref","unstructured":"Rodin GM, Daneman D: Eating disorders and IDDM: a problematic association. 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