Endocrine Abstracts

Background: The problem of eating disorders currently holds a special place in clinical practice. Bulimia nervosa is one of the main forms of eating disorders, characterized by difficulty in treatment, a long, recurrent course. Eating disorders are common in patients with type 1 diabetes mellitus (T1D), especially in adolescent girls.

Case Presentation: In this article, we present a clinical case of a 29-year-old patient with T1D for 14 years and bulimia nervosa, which developed before the manifestation of T1D and progressed against its background. The patient is overly concerned with controlling body weight, specifically restricted the intake of carbohydrates, forcibly caused vomiting. During pregnancy fasting ketonuria ("low-carb ketone") was repeatedly detected. The minimum weight was 37 kg (BMI 15.2 kg/m²). Particular interest of this case is the course of pregnancy, which ended in antenatal death. The possible cause could be the restriction on carbohydrate food and prolonged stay in ketosis, that might lead to the development of pregnancy pathology. Additional examination also revealed multiple complications of diabetes and recurrent depressive disorder.

Conclusion: Combination of T1D and eating disorder requires conjoint monitoring by an endocrinologist and a psychiatrist and should be considered as a atypical course of the disease.