糖尿病コントロール中に大食症を合併した1症例

A Diabetic Becoming Bulimic upon Dietary Control

　抄録　20歳時に糖尿病を診断され，そのコントロールのため入退院を繰り返すうちに，23歳頃から典型的なbinge eatingを始めbulimiaを呈した1女性例を報告した。bulimiaの発症にはしばしば美容を目的とした減食期の先行することが知られているが，本例では糖尿病コントロールのための食事療法が同様の契機となったと考えられた。このような意図的節食の失敗がloss of self-controlとしてbinge eatingへ導く心理機制を，症例の心理検査・治療過程から得られた所見を基に指摘した。

　糖尿病とbulimiaの合併はその生命予後の重篤さ，難治性，およびbulimiaの心理機制の理解への寄与からして格別の注目に値すると思われる．

　Strong concern over ca oric intake is a common feature both in diabetes me itus and eating disorders. However, reports about the association of these relativey common conditions are few. Diabetes me itus with bu imia seems to merit specia medica interest because of its life-threatening nature.

　We reported a case of fema e with diabetes me itus, who deve oped bu imia after repeated fai ures at dietary contro . Diabetes me itus was diagnosed at the age of 20 years, when she was working in a factory away from home. She subsequently returned home but was hospitalized in order to control her physcial illness. She was on oral antidiabetics and, during the first two hospitalizations, she followed the doctor's advice well, without any binge eating. After discharge from the second hospital and after being told that diabetes mellitus cannot be cured, however, she no longer followed the dietary regime and repeatedly indulged in binge eating. She frequently changed hospitals, for she was often scolded by physicians for not following their directions. Insulin therapy was initiated.