Thyrotoxicosis resembling an eating disorder in Type 1 diabetes mellitus

✍ Scribed by Thomas, DJB

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 247 KB
• Volume: 15
• Category: Article
• ISSN: 1357-8170
• DOI: 10.1002/pdi.1960150212

✦ Synopsis

Abstract

A female with Type 1 diabetes, aged 24, presented with mild ketoacidosis and amenorrhea. Subsequent outpatient diabetic control remained poor (HbA~1c~ 13, NR 4.1–5.5) and the patient admitted spending up to ±20 daily on sweets and cakes. Following referral to a psychologist, an eating disorder was diagnosed. Soon after this, thyrotoxicosis (T4 64 pmol/L, range 9–24) was diagnosed following complaints of intense hunger. However, no other usual signs of thyrotoxicosis were present. Once thyrotoxicosis was controlled on carbimazole binging decreased and diabetes control gradually improved. In retrospect the eating disorder was atypical, as vomiting, purging or disturbance of body image were absent. Currently the patient is euthyroid, off treatment, and diabetes control is good (HbA~1c~ 7). It is suggested that thyrotoxicosis may resemble an eating disorder and that thyroid function be assessed in patients with atypical eating disorders even if clinical signs of thyrotoxicosis are absent.