Komorbidität von Essstörungen und Diabetes mellitus Typ 1: Genese, Prävalenz und Interventionsmöglichkeiten

Zusammenfassung

Für Typ-1-Diabetes (T1 D) als eine Autoimmunerkrankung, die meist im Schul- oder jungen Adoleszenzalter manifest wird, ist ein intensives Standardbehandlungsprogramm mit Hauptfokus auf Ernährung und Essstruktur sowie intensivierter Insulintherapie vorgesehen. Eine Assoziation mit Essstörungen wie der Anorexia nervosa (AN), der Bulimia nervosa (BN) oder atypischen Essstörungen (EDNOS), die einen ähnlichen Ersterkrankungsgipfel wie der T1 D haben, ist bereits vielfach beschrieben worden. Diese Komorbidität führt zu schlechteren Stoffwechseleinstellungen und einem deutlich erhöhten Mortalitätsrisiko der betroffenen Patienten. Die duale Therapie der psychischen und der somatischen Erkrankung ist eine Herausforderung für Behandler wie auch für Patienten. Interdisziplinäre Behandlungsmanuale fehlen. Ein rasches Erkennen einer vorliegenden Essstörung ist für den weiteren Krankheitsverlauf von großer Bedeutung. Neben dem Management der entgleisten Stoffwechsellage sollte eine zügige Einleitung einer psychosomatischen Behandlung der Essstörung erfolgen. Screeninginstrumente können bei der Identifizierung helfen. Eine gezielte Prävention im Sinne von Psychoedukation der Risikogruppe der an T1 D erkrankten jungen Frauen kann wichtig sein, um der Entwicklung einer Körperschemastörung und der folgenden Essstörung mit Insulin-Purging-Verhalten entgegenzuwirken.

• Literatur

• 1 Teufel M, Zipfel S. Anorexia nervosa und Bulimia nervosa im Erwachsenenalter. In: Herpertz S, de Zwaan M, Zipfel S. Hrsg. Handbuch Essstörungen und Adipositas. Heildeberg: Springer; 2008: 14-18
• 2 Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet 2010; 375: 583-593
• 3 Stunkard AJ. Eating patterns and obesity. Psychiatr Q 1959; 33: 284-295
• 4 de Zwaan M, Mühlhans B. Atypische Essstörungen und Binge-Eating-Störung. In: Herpertz S, de Zwaan M, Zipfel S. Hrsg. Handbuch Essstörungen und Adipositas. Heidelberg: Springer; 2008: 24-28
• 5 Fairburn CG, Harrison PJ. Eating disorders. Lancet 2003; 361: 407-416
• 6 Rosenbauer J, Stahl A. Häufigkeit des Diabetes mellitus im Kindes- und Jugendalter in Deutschland. Diabetologe 2010; 6: 177-189
• 7 Neu A, Ehehalt S, Feldhahn LM. Diabeteshäufigkeit bei Kindern und Jugendlichen in Deutschland. 20 Jahre Diabetes-Inzidenzregister Baden-Württemberg. Diabetologie 2008; 3: 309-313
• 8 Holling H, Schlack R. Eating disorders in children and adolescents. First results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2007; 50: 794-799
• 9 Lucas AR, Beard CM, O‘Fallon WM et al. 50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study. Am J Psychiatry 1991; 148: 917-922
• 10 Hoek HW, van Hoeken D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord 2003; 34: 383-396
• 11 Lucas AR, Crowson CS, O’Fallon WM et al. The ups and downs of anorexia nervosa. Int J Eat Disord 1999; 26: 397-405
• 12 Steinhausen HC. The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 2002; 159: 1284-1293
• 13 Currin L, Schmidt U, Treasure J et al. Time trends in eating disorder incidence. Br J Psychiatry 2005; 186: 132-135
• 14 Fichter M. Prävalenz und Inzidenz anorektischer und bulimischer Essstörungen. In: Herpertz S, de Zwaan M, Zipfel S. Hrsg. Handbuch Essstörungen und Adipositas. Heidelberg: Springer; 2008: 38-43
• 15 Jones JM, Lawson ML, Daneman D et al. Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study. BMJ 2000; 320: 1563-1566
• 16 Pinar R. Disordered eating behaviors among Turkish adolescents with and without type 1 diabetes. J Pediatr Nurs 2005; 20: 383-388
• 17 Rosenbauer J, Icks A, Giani G. Incidence and prevalence of childhood type 1 diabetes mellitus in Germany – model-based national estimates. J Pediatr Endocrinol Metab 2002; 15: 1497-1504
• 18 Rosenbauer J, Icks A, Schmitter D et al. Incidence of childhood Type I diabetes mellitus is increasing at all ages in Germany. Diabetologia 2002; 45: 457-458
• 19 Mannucci E, Rotella F, Ricca V et al. Eating disorders in patients with type 1 diabetes: a meta-analysis. J Endocrinol Invest 2005; 28: 417-419
• 20 Colton P, Olmsted M, Daneman D et al. Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study. Diabetes Care 2004; 27: 1654-1659
• 21 Ackard DM, Vik N, Neumark-Sztainer D et al. Disordered eating and body dissatisfaction in adolescents with type 1 diabetes and a population-based comparison sample: comparative prevalence and clinical implications. Pediatr Diabetes 2008; 9: 312-319
• 22 Engstrom I, Kroon M, Arvidsson CG et al. Eating disorders in adolescent girls with insulin-dependent diabetes mellitus: a population-based case-control study. Acta Paediatr 1999; 88: 175-180
• 23 Svensson M, Engstrom I, Aman J. Higher drive for thinness in adolescent males with insulin-dependent diabetes mellitus compared with healthy controls. Acta Paediatr 2003; 92: 114-117
• 24 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: 1581-1589
• 25 Young V, Eiser C, Johnson B et al. Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysis. Diabet Med 2013; 30: 189-198
• 26 Sosenko JM, Palmer JP, Rafkin LE et al. Trends of earlier and later responses of C-peptide to oral glucose challenges with progression to type 1 diabetes in diabetes prevention trial-type 1 participants. Diabetes Care 2010; 33: 620-625
• 27 Atkinson MA, Eisenbarth GS, Michels AW. Type 1 diabetes. Lancet 2014; 383: 69-82
• 28 White NH, Sun W, Cleary PA et al. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial. Arch Ophthalmol 2008; 126: 1707-1715
• 29 Pop-Busui R, Low PA, Waberski BH et al. Effects of prior intensive insulin therapy on cardiac autonomic nervous system function in type 1 diabetes mellitus: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study (DCCT/EDIC). Circulation 2009; 119: 2886-2893
• 30 Waden J, Forsblom C, Thorn LM et al. A1C variability predicts incident cardiovascular events, microalbuminuria, and overt diabetic nephropathy in patients with type 1 diabetes. Diabetes 2009; 58: 2649-2655
• 31 Bulik CM, Tozzi F, Anderson C et al. The relation between eating disorders and components of perfectionism. Am J Psychiatry 2003; 160: 366-368
• 32 Groß G. Verhaltenstherapeutische Modellvorstellungen. In: Herpertz S, de Zwaan M, Zipfel S. Hrsg. Handbuch Essstörungen und Adipositas. Heidelberg: Springer; 2008: 54-58
• 33 Munsch S, Herpertz S. Essstörungen bei Adipositas und Diabetes mellitus. Nervenarzt 2011; 82: 1125-1132
• 34 Herpertz S, Albus C, Wagener R et al. Comorbidity of diabetes and eating disorders: Does diabetes control reflect disturbed eating behavior?. Diabetes Care 1998; 21: 1110-1116
• 35 Domargard A, Sarnblad S, Kroon M et al. Increased prevalence of overweight in adolescent girls with type 1 diabetes mellitus. Acta Paediatr 1999; 88: 1223-1228
• 36 Rodin G, Olmsted MP, Rydall AC et al. Eating disorders in young women with type 1 diabetes mellitus. J Psychosom Res 2002; 53: 943-949
• 37 Pietilainen KH, Virtanen SM, Rissanen A et al. Diet, obesity, and metabolic control in girls with insulin dependent diabetes mellitus. Arch Dis Child 1995; 73: 398-402
• 38 Danne T, Kordonouri O, Enders I et al. Factors influencing height and weight development in children with diabetes. Results of the Berlin Retinopathy Study. Diabetes Care 1997; 20: 281-285
• 39 Stancin T, Link DL, Reuter JM. Binge eating and purging in young women with IDDM. Diabetes Care 1989; 12: 601-603
• 40 Colton PA, Olmsted MP, Daneman D et al. Five-year prevalence and persistence of disturbed eating behavior and eating disorders in girls with type 1 diabetes. Diabetes Care 2007; 30: 2861-2862
• 41 Rydall AC, Rodin GM, Olmsted MP et al. Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. N Engl J Med 1997; 336: 1849-1854
• 42 Bryden KS, Neil A, Mayou RA et al. Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care 1999; 22: 1956-1960
• 43 Bryden KS, Peveler RC, Stein A et al. Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study. Diabetes Care 2001; 24: 1536-1540
• 44 Vila G, Robert JJ, Nollet-Clemencon C et al. Eating and emotional disorders in adolescent obese girls with insulin-dependent diabetes mellitus. Eur Child Adolesc Psychiatry 1995; 4: 270-279
• 45 Colas C. Eating disorders and retinal lesions in Type 1 (insulin-dependent) diabetic women. Diabetologia 1991; 34: 288-288
• 46 Takii M, Uchigata Y, Tokunaga S et al. The duration of severe insulin omission is the factor most closely associated with the microvascular complications of Type 1 diabetic females with clinical eating disorders. Int J Eat Disord 2008; 41: 259-264
• 47 Goebel-Fabbri AE, Fikkan J, Franko DL et al. Insulin restriction and associated morbidity and mortality in women with type 1 diabetes. Diabetes Care 2008; 31: 415-419
• 48 Nielsen S, Emborg C, Molbak AG. Mortality in concurrent type 1 diabetes and anorexia nervosa. Diabetes Care 2002; 25: 309-312
• 49 Rodin GM, Daneman D. Eating disorders and IDDM. A problematic association. Diabetes Care 1992; 15: 1402-1412
• 50 Tierney S, Deaton C, Whitehead J. Caring for people with type 1 diabetes mellitus engaging in disturbed eating or weight control: a qualitative study of practitioners’ attitudes and practices. J Clin Nurs 2009; 18: 384-390
• 51 Powers MA, Richter S, Ackard D et al. Characteristics of persons with an eating disorder and type 1 diabetes and psychological comparisons with persons with an eating disorder and no diabetes. Int J Eat Disord 2012; 45: 252-256
• 52 Kelly SD, Howe CJ, Hendler JP et al. Disordered eating behaviors in youth with type 1 diabetes. Diabetes Educ 2005; 31: 572-583
• 53 Goebel-Fabbri AE. Diabetes and eating disorders. J Diabetes Sci Technol 2008; 2: 530-532
• 54 Pinhas-Hamiel O, Hamiel U, Greenfield Y et al. Detecting intentional insulin omission for weight loss in girls with type 1 diabetes mellitus. Int J Eat Disord 2013; 46: 819-825
• 55 Bahrke U, Bandemer-Greulich U, Fikentscher E. Erfassung essgestörten Verhaltens bei Patientinnen mit Diabetes mellitus mit Hilfe eines Fragebogens (Diab-Ess). Diabetologie und Stoffwechsel 2006; 1: 46-53
• 56 Stice E, Marti N, Shaw H et al. General and program-specific moderators of two eating disorder prevention programs. Int J Eat Disord 2008; 41: 611-617
• 57 Shaw H, Stice E, Becker CB. Preventing eating disorders. Child Adolesc Psychiatr Clin N Am 2009; 18: 199-207
• 58 Wilksch SM, Starkey K, Gannoni A et al. Interactive programme to enhance protective factors for eating disorders in girls with type 1 diabetes. Early Interv Psychiatry 2013; 7: 315-321
• 59 Olmsted MP, Daneman D, Rydall AC et al. The effects of psychoeducation on disturbed eating attitudes and behavior in young women with type 1 diabetes mellitus. Int J Eat Disord 2002; 32: 230-239
• 60 Alloway SC, Toth EL, McCargar LJ. Effectiveness of a group psychoeducation program for the treatment of subclinical disordered eating in women with type 1 diabetes. Can J Diet Pract Res 2001; 62: 188-192
• 61 Keifenheim KE, Becker S, Mander J et al. Motivational Interviewing – Hintergründe, Methode, Möglichkeiten. Psychother Psych Med 2013; 63: 150-160