Eating disorders and carbohydrate metabolism interrelations

Authors

  • Sylwiusz Niedobylski Diabetology Division of Students’ Research Group at the Chair and Department of Endocrinology, Diabetology and Metabolic Disorders, Medical University of Lublin, Poland Author https://orcid.org/0000-0001-7266-623X
  • Małgorzata Skarbek Diabetology Division of Students’ Research Group at the Chair and Department of Endocrinology, Diabetology and Metabolic Disorders, Medical University of Lublin, Poland Author https://orcid.org/0000-0001-6227-4283
  • Justyna Tomasik Diabetology Division of Students’ Research Group at the Chair and Department of Endocrinology, Diabetology and Metabolic Disorders, Medical University of Lublin, Poland Author https://orcid.org/0000-0001-6114-6992
  • Bartłomiej Zaręba Diabetology Division of Students’ Research Group at the Chair and Department of Endocrinology, Diabetology and Metabolic Disorders, Medical University of Lublin, Poland Author https://orcid.org/0000-0002-3255-2745
  • Żaneta Zawadzka Diabetology Division of Students’ Research Group at the Chair and Department of Endocrinology, Diabetology and Metabolic Disorders, Medical University of Lublin, Poland Author https://orcid.org/0000-0002-5364-1982
  • Michał Próchnicki I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Poland Author https://orcid.org/0000-0001-8993-9767
  • Grzegorz Rudzki https://orcid.org/0000-0003-0929-9419 Author

DOI:

https://doi.org/10.2478/cpp-2022-0008

Keywords:

eating disorders, anorexia nervosa, glucose metabolism disorders

Abstract

Introduction. Eating disorders are characterised by persistent disturbances in eating behavior, resulting in severe carbohydrate homeostasis changes. The aim of the study is to review mutual correlations between eating disorders, with emphasis on anorexia nervosa, and carbohydrate metabolism, including glycemia and the levels of relevant hormones.

Material and methods. A priori general inclusion criteria were established and included patients with eating disorders or with glucose metabolism disorders. A MEDLINE database review was carried out. Relevant articles have been extracted and approved by supervisor.

Results. 40 studies got included in the review. Patients with active anorexia nervosa display low levels of fasting and postprandial glucose, decreased lipid metabolism, and decreased pancreatic endocrine activity. Insulin levels remain changed even after patient’s re-nourishment – insulin response tends to be delayed and decreased compared to patients without anorexia history. Eating disorders are associated with poorer glycemic control and a higher percentage of diabetic complications in patients with pre-existing diabetes – mostly type I. There are also reports of higher carbohydrate metabolism disturbances among patients with eating disorders.

Conclusions. Carbohydrate metabolism disorders and eating disorders are clearly interrelated, although data on the nature of these relationships are still lacking. Treatment of eating disorders is not possible without normalizing eating patterns, thus also carbohydrate metabolism. However, it is not usual to monitor the mental state in terms of eating disorders potential development in patients during the treatment of carbohydrate disorders. According to existing data, this approach should be changed due to the risk of anorexia nervosa and other eating disorders in this group.

References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.; DSM-5). 2013.

2. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020.

3. Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. Lancet Psychiatry. 2021;8(4):320-8.

4. Marucci S, Ragione LD, De Iaco G, et al. Anorexia Nervosa and Comorbid Psychopathology. Endocr Metab Immune Disord Drug Targets. 2018;18(4):316-24.

5. Morylowska-Topolska J, Ziemiński R, Molas A, et al. Schizophrenia and anorexia nervosa - reciprocal relationships. A literature review. Psychiatr Pol. 2017;51(2):261-70.

6. Casper RC. Carbohydrate metabolism and its regulatory hormones in anorexia nervosa. Psychiatry Res. 1996;62(1):85-96.

7. Alderdice JT, Dinsmore WW, Buchanan KD, Adams C. Gastrointestinal hormones in anorexia nervosa. J Psychiatr Res. 1985;19(2-3):207-13.

8. Heruc GA, Little TJ, Kohn MR, et al. Effects of starvation and short-term refeeding on gastric emptying and postprandial blood glucose regulation in adolescent girls with anorexia nervosa. American Journal of Physiology-Endocrinology and Metabolism. 2018;315(4):E565-73.

9. Gniuli D, Liverani E, Capristo E, Greco AV, Mingrone G. Blunted glucose metabolism in anorexia nervosa. Metabolism. 2001;50(8):876-81.

10. Misra M, Miller KK, Almazan C, et al. Alterations in Cortisol Secretory Dynamics in Adolescent Girls with Anorexia Nervosa and Effects on Bone Metabolism. The Journal of Clinical Endocrinology & Metabolism. 2004;89(10):4972-80.

11. Misra M, Miller KK, Cord J, et al. Relationships between Serum Adipokines, Insulin Levels, and Bone Density in Girls with Anorexia Nervosa. The Journal of Clinical Endocrinology & Metabolism. 2007;92(6):2046-52.

12. Ilyas A, Hübel C, Stahl D, et al. The metabolic underpinning of eating disorders: A systematic review and meta-analysis of insulin sensitivity. Molecular and Cellular Endocrinology. 2019;497:110307.

13. Prince AC, Brooks SJ, Stahl D, Treasure J. Systematic review and meta-analysis of the baseline concentrations and physiologic responses of gut hormones to food in eating disorders. The American Journal of Clinical Nutrition. 2009;89(3):755-65.

14. Broberg DJ, Bernstein IL. Cephalic insulin release in anorexic women. Physiol Behav. 1989;45(5):871-4.

15. Counts DR, Gwirtsman H, Carlsson LM, Lesem M, Cutler GBJ. The effect of anorexia nervosa and refeeding on growth hormone-binding protein, the insulin-like growth factors (IGFs), and the IGF-binding proteins. J Clin Endocrinol Metab. 1992;75(3):762-7.

16. Gianotti L, Lanfranco F, Ramunni J, Destefanis S, Ghigo E, Arvat E. GH/IGF-I axis in anorexia nervosa. Eat Weight Disord. 2002;7(2):94-105.

17. Argente J, Caballo N, Barrios V, et al. Multiple endocrine abnormalities of the growth hormone and insulin-like growth factor axis in patients with anorexia nervosa: effect of short-and long-term weight recuperation. J Clin Endocrinol Metab. 1997;82(7):2084-92.

18. Audi L, Mantzoros CS, Vidal-Puig A, Vargas D, Gussinye M, Carrascosa A. Leptin in relation to resumption of menses in women with anorexia nervosa. Mol Psychiatry. 1998;3(6):544-7.

19. Caregaro L, Favaro A, Santonastaso P, et al. Insulin-like growth factor 1 (IGF-1), a nutritional marker in patients with eating disorders. Clin Nutr. 2001;20(3):251-7.

20. Brown NW, Ward A, Surwit R, et al. Evidence for metabolic and endocrine abnormalities in subjects recovered from anorexia nervosa. Metabolism. 2003;52(3):296-302.

21. Kumai M, Tamai H, Fujii S, Nakagawa T, Aoki TT. Glucagon secretion in anorexia nervosa. Am J Clin Nutr. 1988;47(2):239-42.

22. Kinzig KP, Coughlin JW, Redgrave GW, Moran TH, Guarda AS. Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration. Am J Physiol Endocrinol Metab. 2007;292(5):E1441-1446.

23. Nakahara T, Kojima S, Tanaka M, et al. Incomplete restoration of the secretion of ghrelin and PYY compared to insulin after food ingestion following weight gain in anorexia nervosa. J Psychiatr Res. 2007;41(10):814-20.

24. Kim Y, Hildebrandt T, Mayer LES. Differential glucose metabolism in weight restored women with anorexia nervosa. Psychoneuroendocrinology. 2019;110:104404.

25. Prioletta A, Muscogiuri G, Sorice GP, et al. In anorexia nervosa, even a small increase in abdominal fat is responsible for the appearance of insulin resistance. Clin Endocrinol (Oxf). 2011;75(2):202-6.

26. Modan-Moses D, Stein D, Pariente C, et al. Modulation of adiponectin and leptin during refeeding of female anorexia nervosa patients. J Clin Endocrinol Metab. 2007;92(5):1843-7.

27. Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect. 2020;10(2):98-115.

28. Reinehr T, Dieris B, Galler A, et al. Worse Metabolic Control and Dynamics of Weight Status in Adolescent Girls Point to Eating Disorders in the First Years after Manifestation of Type 1 Diabetes Mellitus: Findings from the Diabetes Patienten Verlaufsdokumentation Registry. The Journal of Pediatrics. 2019;207:205-212.e5.

29. Larrañaga A, Docet MF, García-Mayor RV. Disordered eating behaviors in type 1 diabetic patients. WJD. 2011;2(11):189.

30. Crow SJ, Keel PK, Kendall D. Eating disorders and insulin-dependent diabetes mellitus. Psychosomatics. 1998;39(3):233-43.

31. Biggs MM, Basco MR, Patterson G, Raskin P. Insulin withholding for weight control in women with diabetes. Diabetes Care. 1994;17(10):1186-9.

32. Scheuing N, Bartus B, Berger G, et al. 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. Diabetes Care. 2014;37(6):1581-9.

33. Al Hourani H, Ababneh R, Khawaja N, Khader Y, Ajlouni K. Eating disorders among Jordanian adolescents with and without dysglycaemia: a comparative study. East Mediterr Health J. 2020;26(12):1502-9.

34. Toni G, Berioli MG, Cerquiglini L, et al. Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients. 2017;9(8):906.

35. Winston AP. Eating Disorders and Diabetes. Curr Diab Rep. 2020;20(8):32.

36. Rodin GM, Craven J, Littlefield C, Goldbloom D, Daneman D. Insulin misuse through omission or reduction of dose. Psychosomatics. 1989;30(4):465-6.

37. Peveler RC, Bryden KS, Neil HAW, et al. The relationship of disordered eating habits and attitudes to clinical outcomes in young adult females with type 1 diabetes. Diabetes Care. 2005;28(1):84-8.

38. Clausen L, Rosenvinge JH, Friborg O, Rokkedal K. Validating the Eating Disorder Inventory-3 (EDI-3): A Comparison Between 561 Female Eating Disorders Patients and 878 Females from the General Population. J Psychopathol Behav Assess. 2011;33(1):101-10.

39. Zuijdwijk CS, Pardy SA, Dowden JJ, Dominic AM, Bridger T, Newhook LA. The mSCOFF for screening disordered eating in pediatric type 1 diabetes. Diabetes Care. 2014;37(2):e26-27.

40. Markowitz JT, Lowe MR, Volkening LK, Laffel LMB. Self-reported history of overweight and its relationship to disordered eating in adolescent girls with Type 1 diabetes. Diabet Med. 2009;26(11):1165-71.

Downloads

Published

2022-08-28