Depression, Disturbed Eating Behavior, and Metabolic Control in Teenage Girls With Type 1 Diabetes.

Depression, disturbed eating behavior, and metabolic control in teenage girls with type 1 diabetes.

Filed under: Eating Disorders

Pediatr Diabetes. 2013 Feb 19;
Colton PA, Olmsted MP, Daneman D, Rodin GM

BACKGROUND: Depression and disturbed eating behavior (DEB) are more common in girls with type 1 diabetes (T1D) than in the general population, and may negatively affect metabolic control. OBJECTIVE: To examine the relationship among depression, DEB, and metabolic control in teenage girls with T1D. METHODS: Metabolic control, body mass index and interview-ascertained symptoms of depression, and DEB were assessed twice in 98 girls with T1D, 9-14 y at baseline and 5?yr later at 14-18 yr. RESULTS: At year 5, 12.2% of girls reported current depressive symptoms, 49.0% reported current DEB, and 13.3% had a full or subthreshold eating disorder (ED). Eating Disorder Examination score was higher in girls with depression (1.4?±?1.3 vs. 0.5?±?0.7; p?=?0.03), and 75.0% of girls with depression also endorsed DEB vs. 45.3% of girls without depression (p?=?0.05). Girls with an ED were at high risk for depressive symptoms; 69.2% reported depressive symptoms vs. 22.0% of girls with no DEB (p?=?0.004). Metabolic control was not significantly associated with either depression or DEB in this cohort. A regression model using baseline and year 5 depression and DEB to predict year 5 hemoglobin A1c was not significant overall. CONCLUSIONS: Depression and DEB were common and frequently concurrent in this cohort. It was encouraging that poor metabolic control was not yet strongly associated with either depression or DEB. Early detection and treatment may help to prevent the development of entrenched difficulties in this triad of mood, eating behavior, and metabolic control in a vulnerable population.
HubMed – eating

Conversion of Vertical Banded Gastroplasty to Stand-Alone Sleeve Gastrectomy or Biliopancreatic Diversion with Duodenal Switch.

Filed under: Eating Disorders

J Gastrointest Surg. 2013 Feb 16;
Jain-Spangler K, Portenier D, Torquati A, Sudan R

INTRODUCTION: Vertical banded gastroplasty (VBG) originated as a simplified bariatric operation to avoid malabsorption and provide lasting results due to a fixed stoma. Short-term results were excellent (50-70 % excess weight loss); however, patients often displayed maladaptive eating behaviors, and many failed to either achieve or sustain adequate long-term weight loss. Complications were also common including severe reflux and regurgitation, gastric outlet stenosis or stricture, gastrogastric fistula, and breakdown of the staple line. METHODS: VBG conversions to Roux-en-Y gastric bypass or sleeve gastrectomy as well as endoscopic interventions such as band removal have been described but have very high complication rates. We describe conversion of VBG to biliopancreatic diversion with duodenal switch using endoscopic guidance to take down the VBG staple line and the mesh around the outlet. RESULTS: This technique can also be used to safely convert a VBG to a stand-alone sleeve gastrectomy. CONCLUSION: Complication rates have been low by this technique, and we encourage others to adopt this technique.
HubMed – eating

An unusual cause of spontaneous bacterial peritonitis due to Campylobacter fetus with alcoholic liver cirrhosis.

Filed under: Eating Disorders

BMJ Case Rep. 2013; 2013(feb14_1):
Hadano Y, Iwata H

A 40-year-old man with severe alcoholic liver cirrhosis with a 2-day history of fatigue and abdominal pain was admitted. He reported eating sushi and sliced raw chicken a few days previously. His abdomen was distended, with shifting dullness. Based on the patient’s history, physical examination and the results of abdominocentesis, he was diagnosed as having spontaneous bacterial peritonitis; blood and ascitic fluid cultures were positive for Campylobacter fetus. The patient was started on treatment with cefotaxime, which was switched after 1 week to ampicillin for an additional 3 weeks. The patient was successfully treated with the 4-week course of intravenous antibiotic therapy.
HubMed – eating

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