Eating Disorders in Adolescent Girls and Young Adult Women With Type 1 Diabetes

Preface

Dennis Daneman, MB, BCh, FRCPC

Teens with type 1 diabetes face two clashing realities. On the one hand, the results of studies such as the Diabetes Control and Complications Trial (DCCT) provide irrefutable evidence of the link between diabetes control and the onset and progression of diabetes-related microvascular complications.1 The DCCT message was loud and clear: Control counts! On the other hand, there are numerous studies, including the DCCT, demonstrating that, during adolescence, metabolic control tends to be poorest and that the goals of intensive diabetes management are more difficult to achieve.2^,3

What are the reasons for poor glycemic control in adolescents with type 1 diabetes? I believe that it results from the complex interplay between biological (e.g., insulin resistance of puberty) and psychosocial (e.g., noncompliance, family environment) factors. Our group has focused on one specific contributing factor, namely, eating disorders in teenage girls with type 1 diabetes. This From Research to Practice section offers a review of this topic by our research group at the University of Toronto.

This is a departure from the usual format of Diabetes Spectrum research sections in that the entire section comprises contributions from a single research group. A number of groups around the world have made substantial contributions to this field, and we have been as diligent as possible in citing their enormous contributions. However, we do hope that our group has been able to provide a unifying view of the pathophysiology and impact of eating disturbances in girls and young women with type 1 diabetes. Our aim is to sensitize readers to the manifestations of this common co-morbidity and to highlight areas where further research is warranted.

Because this monograph-style presentation represents the combined efforts of all of the authors, we have listed only the primary contributors to …