[Fear of allowing sugar into the cell--case 05/2009. Comorbidity of diabetes mellitus and eating disorders].

HISTORY AND ADMISSION FINDINGS: An 19-year-old female patient was admitted to our department of psychosomatic medicine and psychotherapy for the treatment of her metabolically deranged type 1 diabetes mellitus.

INVESTIGATIONS: Exploration and assessment revealed a typical eating disorder symptomatology. The body mass index at time of admission was 18.7 kg/m (2). Episodes of binge eating were followed by purging behaviour (insulin purging, vomiting).

DIAGNOSIS, TREATMENT AND COURSE: After diagnosis of bulimia nervosa, the patient was treated with a structured dual treatment regime consisting of psychosomatic/psychotherapeutic interventions and endocrinological support. The existing complex bio-psycho-social conditions were considered carefully. In the treatment course typical eating disorder behaviour (i. e. insulin purging) decreased and mood stabilised.

CONCLUSIONS

Adolescent women with diabetes mellitus are at an increased risk of developing an eating disorder. This comorbidity is associated with a markedly increased mortality. Therefore, diagnosis of an eating disorder should be made as soon as possible in order to provide adequate treatment not only for the metabolic disturbances but also for the coexisting psychosomatic disorder.