Alexithymic Characteristics of Bulimia Nervosa in Diabetes Mellitus with End-Stage Renal Disease

1997 ◽  
Vol 81 (2) ◽  
pp. 627-633 ◽  
Author(s):  
Isao Fukunishi
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Bulimia Nervosa ◽  
Prevalence Rate ◽  
Diabetic Patients ◽  
Related Factors ◽  
End Stage Renal Failure ◽  
Patients With Diabetes ◽  
Stage Renal Disease ◽  
End Stage

This study examined the clinical characteristics including stress-related factors of eating disorders in a sample of 312 diabetic patients with end-stage renal failure. The prevalence rate of bulimia nervosa was 5.1% (16 of 312 patients). The 16 patients with bulimia nervosa were 8 men and 8 women over 58 years old. Looking at the subjects by cause of end-stage renal failure, those with diabetes mellitus exhibited significantly higher prevalence rate of bulimia nervosa than two nondiabetic groups (diabetes 10%; nephritis 1.6%; others 1.9%). As for the association of bulimia nervosa and stress-related factors, end-stage renal failure patients with diabetes who exhibited bulimia nervosa showed significantly higher scores on a measure of alexithymia. These results suggest that, when liaison psychiatrists see diabetic patients with end-stage renal failure who exhibit bulimia nervosa, they should pay close attention to stress-related symptoms including alexithymia.

scholarly journals Hand osteomyelitis in arterial calcification, diabetes mellitus and end-stage renal failure: a comparison of 210 cases over 12 years

2021 ◽  
pp. 175319342098187
Author(s):  
Matthew Wyman ◽  
Dallan Dargan ◽  
Jennifer Caddick ◽  
Victoria Giblin
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Disease Free Survival ◽  
Arterial Calcification ◽  
Level Of Evidence ◽  
Free Survival ◽  
End Stage Renal Failure ◽  
Patients With Diabetes ◽  
End Stage ◽  
Steal Syndrome

We present 210 patients with hand osteomyelitis in 246 rays over 12 years, including detailed analysis of 29 patients in this cohort with digital artery calcification evident on plain X-ray. Overall 71 patients had diabetes mellitus and/or end-stage renal failure, including 28 of 29 patients with calcification. In the calcification group, 17 patients had ipsilateral arteriovenous fistulae, five had steal syndrome and 15 had digital ulceration or skin necrosis. Compared with 181 controls, patients with calcification had more affected bones, polymicrobial infections, surgical procedures, phalanges and digits amputated and had higher mortality at 1 year (12 of 29) and 5 years (20 of 29), as a result of comorbidities. Absence of calcification in 43 patients with diabetes and/or end-stage renal failure was associated with better outcomes on all the above parameters. Early amputation to maximize disease-free survival may be appropriate for patients with hand osteomyelitis and arterial calcification. Level of evidence: IV

scholarly journals Mortality after amputation in dialysis patients is high but not modified by diabetes status

2019 ◽  
Vol 13 (6) ◽  
pp. 1077-1082 ◽  
Author(s):  
Marielle A Schroijen ◽  
Merel van Diepen ◽  
Jaap F Hamming ◽  
Friedo W Dekker ◽  
Olaf M Dekkers
Keyword(s):  
Mortality Risk ◽  
Interaction Analysis ◽  
Diabetic Patients ◽  
Comorbid Conditions ◽  
Dialysis Patients ◽  
Diabetes Status ◽  
Patients With Diabetes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Incident Cases

Abstract Background Survival among dialysis patients with diabetes mellitus (DM) is inferior to survival of non-diabetic dialysis patients, probably due to the higher prevalence of diabetes-related comorbid conditions. One could hypothesize that these comorbid conditions also contribute to a decreased survival after amputation in diabetic patients compared with non-diabetic patients on dialysis. Methods Data were collected from the Netherlands Cooperative Study on the Adequacy of Dialysis, a multicentre, prospective cohort study in which new patients with end-stage renal disease were monitored until transplantation or death. Amputation rates (incident cases) were calculated in patients with and without DM. The primary endpoint was all-cause survival after first amputation during dialysis therapy in diabetic patients compared with non-diabetic dialysis patients with an amputation. This was formally assessed using interaction analysis (Poisson regression). Results During follow-up (mean duration 2.9 years), 50 of the 413 diabetic patients had a new amputation (12.1%), compared with 20 of 1553 non-diabetic patients (1.2%). Amputation rates/1000 person-years were 47.9 [95% confidence interval (CI) 36.3–63.2] and 4.1 (95% CI 2.7–6.4), respectively, for diabetic patients and non-diabetic patients. Amputation increased mortality risk more than 4-fold in patients without diabetes [hazard ratio (HR) 4.6 (95% CI 2.8–7.6)] as well as in patients with diabetes [HR 4.6 (95% CI 3.3–6.4)]. No formal interaction between diabetes and amputation was found (P = 0.12). Conclusions Amputation in dialysis patients is associated with a 4-fold increased mortality risk; this mortality risk was similar for diabetes and non-diabetes patients. Importantly, the risk for amputation is 10-fold higher in DM compared with non-diabetic dialysis patients.

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