Hypoglycemia impact on psychiatric symptoms and brain changes in anorexia nervosa
DOI:
https://doi.org/10.12775/JEHS.2024.69.48178Keywords
hypoglycemia, Anorexia nervosa, Diabetes, psychiatric symptomsAbstract
This study examines the potential impact of hypoglycemia on mental comorbidity in anorexia, comparing it to similar changes in diabetes. Anorexia, characterized by low body weight, is linked to hypoglycemia, possibly affecting mental health. Recurrent hypoglycemia in diabetes leads to mood changes and cognitive impairment. Anorexic individuals may experience deficits in cognitive functioning and psychiatric comorbidities, including affective disorders and anxiety. Imaging studies show structural changes in the brains of both anorexia and diabetes patients, but the direct link between hypoglycemia and psychoorganic changes in anorexia remains inconclusive, warranting further investigation.
References
Radden J. Capturing the anorexia nervosa phenotype: Conceptual and normative issues in ICD-11. J Eval Clin Pract. 2022;28(5):807-813. doi:10.1111/jep.13586
Bouquegneau A, Dubois BE, Krzesinski JM, Delanaye P. Anorexia nervosa and the kidney. Am J Kidney Dis. 2012;60(2):299-307. doi:10.1053/j.ajkd.2012.03.019
Wierzchowiecka A, Zozulińska-Ziółkiewicz D, Hypoglycaemia in type 1 diabetes, Clinical Diabetology 2011;12(6):210-215.
2021 Guidelines on the management of patients with diabetes. A position of Diabetes Poland. Clin Diabetol 2021; 10, 1.DOI: 10.5603/DK.2021.0001.
Sakurai-Chin C, Ito N, Taguchi M, Miyakawa M, Takeshita A, Takeuchi Y. Hypoglycemic coma in a patient with anorexia nervosa coincident with acute exacerbation of liver injury induced by oral intake of nutrients. Intern Med. 2010;49(15):1553-1556. doi:10.2169/internalmedicine.49.3373
Mehler PS, Watters A, Joiner T, Krantz MJ. What accounts for the high mortality of anorexia nervosa?. Int J Eat Disord. 2022;55(5):633-636. doi:10.1002/eat.23664
Jáuregui-Garrido B, Jáuregui-Lobera I. Sudden death in eating disorders. Vasc Health Risk Manag. 2012;8:91-98. doi:10.2147/VHRM.S28652
Gaudiani JL, Sabel AL, Mehler PS. Low prealbumin is a significant predictor of medical complications in severe anorexia nervosa. Int J Eat Disord. 2014;47(2):148-156. doi:10.1002/eat.22233
Gaudiani JL, Sabel AL, Mascolo M, Mehler PS. Severe anorexia nervosa: outcomes from a medical stabilization unit. Int J Eat Disord. 2012;45(1):85-92. doi:10.1002/eat.20889
Mohseni S. Neurologic damage in hypoglycemia. Handb Clin Neurol. 2014;126:513-532. doi:10.1016/B978-0-444-53480-4.00036-9
Kodl CT, Seaquist ER. Cognitive dysfunction and diabetes mellitus. Endocr Rev. 2008;29(4):494-511. doi:10.1210/er.2007-0034
Sheen YJ, Sheu WH. Association between hypoglycemia and dementia in patients with type 2 diabetes. Diabetes Res Clin Pract. 2016;116:279-287. doi:10.1016/j.diabres.2016.04.004
Huang L, Zhu M, Ji J. Association between hypoglycemia and dementia in patients with diabetes: a systematic review and meta-analysis of 1.4 million patients. Diabetol Metab Syndr. 2022;14(1):31. Published 2022 Feb 14. doi:10.1186/s13098-022-00799-9
Mehta HB, Mehta V, Goodwin JS. Association of Hypoglycemia With Subsequent Dementia in Older Patients With Type 2 Diabetes Mellitus [published correction appears in J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):750]. J Gerontol A Biol Sci Med Sci. 2017;72(8):1110-1116. doi:10.1093/gerona/glw217
Rhee SY. Hypoglycemia and Dementia. Endocrinol Metab (Seoul). 2017;32(2):195-199. doi:10.3803/EnM.2017.32.2.195
Gómez-Guijarro MD, Álvarez-Bueno C, Saz-Lara A, Sequí-Domínguez I, Lucerón-Lucas-Torres M, Cavero-Redondo I. Association between severe hypoglycaemia and risk of dementia in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2023;39(3):e3610. doi:10.1002/dmrr.3610
Yaffe K, Falvey CM, Hamilton N, et al. Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus. JAMA Intern Med. 2013;173(14):1300-1306. doi:10.1001/jamainternmed.2013.6176
Northam EA, Rankins D, Cameron FJ. Therapy insight: the impact of type 1 diabetes on brain development and function. Nat Clin Pract Neurol. 2006;2(2):78-86. doi:10.1038/ncpneuro0097
Feinkohl I, Aung PP, Keller M, et al. Severe hypoglycemia and cognitive decline in older people with type 2 diabetes: the Edinburgh type 2 diabetes study. Diabetes Care. 2014;37(2):507-515. doi:10.2337/dc13-1384
Asvold BO, Sand T, Hestad K, Bjørgaas MR. Cognitive function in type 1 diabetic adults with early exposure to severe hypoglycemia: a 16-year follow-up study. Diabetes Care. 2010;33(9):1945-1947. doi:10.2337/dc10-0621
Bade-White PA, Obrzut JE. The Neurocognitive Effects of Type 1 Diabetes Mellitus in Children and Young Adults With and Without Hypoglycemia. Journal of Developmental and Physical Disabilities. 2009;21(5):425-440. doi:https://doi.org/10.1007/s10882-009-9151-y
Dogan B, Oner C, Akalin AA, Ilhan B, Caklili OT, Oguz A. Psychiatric symptom rate of patients with Diabetes Mellitus: A case control study. Diabetes Metab Syndr. 2019;13(2):1059-1063. doi:10.1016/j.dsx.2019.01.045
Gilsanz P, Karter AJ, Beeri MS, Quesenberry CP Jr, Whitmer RA. The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes. Diabetes Care. 2018;41(3):446-452. doi:10.2337/dc17-1566
Shao W, Ahmad R, Khutoryansky N, Aagren M, Bouchard J. Evidence supporting an association between hypoglycemic events and depression. Curr Med Res Opin. 2013;29(12):1609-1615. doi:10.1185/03007995.2013.830599
Jeon EJ. Diabetes and depression. Yeungnam Univ J Med. 2018;35(1):27-35. doi:10.12701/yujm.2018.35.1.27
Carter J, Swardfager W. Mood and metabolism: Anhedonia as a clinical target in Type 2 diabetes. Psychoneuroendocrinology. 2016;69:123-132. doi:10.1016/j.psyneuen.2016.04.002
Yau PL, Javier DC, Ryan CM, et al. Preliminary evidence for brain complications in obese adolescents with type 2 diabetes mellitus. Diabetologia. 2010;53(11):2298-2306. doi:10.1007/s00125-010-1857-y
Northam EA, Rankins D, Lin A, et al. Central nervous system function in youth with type 1 diabetes 12 years after disease onset. Diabetes Care. 2009;32(3):445-450. doi:10.2337/dc08-1657
He J, Ryder AG, Li S, Liu W, Zhu X. Glycemic extremes are related to cognitive dysfunction in children with type 1 diabetes: A meta-analysis. J Diabetes Investig. 2018;9(6):1342-1353. doi:10.1111/jdi.12840
Tolu-Kendir O, Kiriş N, Temiz F, et al. Relationship between metabolic control and neurocognitive functions in children diagnosed with type I diabetes mellitus before and after 5 years of age. Turk J Pediatr. 2012;54(4):352-361.
Hamed SA. Brain injury with diabetes mellitus: evidence, mechanisms and treatment implications. Expert Rev Clin Pharmacol. 2017;10(4):409-428. doi:10.1080/17512433.2017.1293521
Kaye WH, Bulik CM, Thornton L, Barbarich N, Masters K. Comorbidity of anxiety disorders with anorexia and bulimia nervosa. Am J Psychiatry. 2004;161(12):2215-2221. doi:10.1176/appi.ajp.161.12.2215
Pollice C, Kaye WH, Greeno CG, Weltzin TE. Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int J Eat Disord. 1997;21(4):367-376. doi:10.1002/(sici)1098-108x(1997)21:4<367::aid-eat10>3.0.co;2-w
Foldi CJ, Milton LK, Oldfield BJ. A focus on reward in anorexia nervosa through the lens of the activity-based anorexia rodent model. J Neuroendocrinol. 2017;29(10):10.1111/jne.12479. doi:10.1111/jne.12479
Dolan SC, Khindri R, Franko DL, Thomas JJ, Reilly EE, Eddy KT. Anhedonia in eating disorders: A meta-analysis and systematic review. Int J Eat Disord. 2022;55(2):161-175. doi:10.1002/eat.23645
Brodrick BB, Jacobs MA, McAdams CJ. Psychosis in Anorexia Nervosa: A Case Report and Review of the Literature. Psychosomatics. 2020;61(2):181-187. doi:10.1016/j.psym.2019.06.003
Curzio O, Calderoni S, Maestro S, et al. Lower gray matter volumes of frontal lobes and insula in adolescents with anorexia nervosa restricting type: Findings from a Brain Morphometry Study. Eur Psychiatry. 2020;63(1):e27. Published 2020 Mar 16. doi:10.1192/j.eurpsy.2020.19
Delsedime N, Nicotra B, Giovannone MC, et al. Psychotic symptoms in a woman with severe Anorexia Nervosa : psychotic symptoms in Anorexia Nervosa. Eat Weight Disord. 2013;18(1):95-98. doi:10.1007/s40519-013-0009-z
Morylowska-Topolska J, Ziemiński R, Molas A, et al. Schizophrenia and anorexia nervosa - reciprocal relationships. A literature review. Schizofrenia i jadłowstręt psychiczny – wzajemne powiązania. Przegląd literatury. Psychiatr Pol. 2017;51(2):261-270. doi:10.12740/PP/OnlineFirst/63514
Bühren K, Schwarte R, Fluck F, et al. Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa. Eur Eat Disord Rev. 2014;22(1):39-44. doi:10.1002/erv.2254
Chui HT, Christensen BK, Zipursky RB, et al. Cognitive function and brain structure in females with a history of adolescent-onset anorexia nervosa. Pediatrics. 2008;122(2):e426-e437. doi:10.1542/peds.2008-0170
Green MW, Elliman NA, Wakeling A, Rogers PJ. Cognitive functioning, weight change and therapy in anorexia nervosa. J Psychiatr Res. 1996;30(5):401-410. doi:10.1016/0022-3956(96)00026-x
Koyama KI, Asakawa A, Nakahara T, et al. Intelligence quotient and cognitive functions in severe restricting-type anorexia nervosa before and after weight gain. Nutrition. 2012;28(11-12):1132-1136. doi:10.1016/j.nut.2012.03.003
Stantonyonge N, Sampedro F, Méndez J, Martínez-Horta S, Chico A, Gómez-Anson B. Structural Gray and White Matter Differences in Patients With Type 1 Diabetes and Impaired Awareness of Hypoglycemia. J Clin Endocrinol Metab. 2021;106(2):450-458. doi:10.1210/clinem/dgaa832
Blasetti A, Chiuri RM, Tocco AM, et al. The effect of recurrent severe hypoglycemia on cognitive performance in children with type 1 diabetes: a meta-analysis. J Child Neurol. 2011;26(11):1383-1391. doi:10.1177/0883073811406730
Shalimova A, Graff B, Gąsecki D, et al. Cognitive Dysfunction in Type 1 Diabetes Mellitus. J Clin Endocrinol Metab. 2019;104(6):2239-2249. doi:10.1210/jc.2018-01315
Musen G, Lyoo IK, Sparks CR, et al. Effects of type 1 diabetes on gray matter density as measured by voxel-based morphometry. Diabetes. 2006;55(2):326-333. doi:10.2337/diabetes.55.02.06.db05-0520
Perantie DC, Wu J, Koller JM, et al. Regional brain volume differences associated with hyperglycemia and severe hypoglycemia in youth with type 1 diabetes. Diabetes Care. 2007;30(9):2331-2337. doi:10.2337/dc07-0351
Mehler PS, Brown C. Anorexia nervosa - medical complications. J Eat Disord. 2015;3:11. Published 2015 Mar 31. doi:10.1186/s40337-015-0040-8
Brown C, Mehler PS. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects. Eat Weight Disord. 2015;20(4):419-425. doi:10.1007/s40519-015-0202-3
Rojo-Moreno L, Plumed JJ, Fons MB, Gonzalez-Piqueras JC, Rojo-Bofill L, Livianos L. Auditory hallucinations in anorexia nervosa. Eur Eat Disord Rev. 2011;19(6):494-500. doi:10.1002/erv.1084
Mishima R, Isobe M, Noda T, et al. Structural brain changes in severe and enduring anorexia nervosa: A multimodal magnetic resonance imaging study of gray matter volume, cortical thickness, and white matter integrity. Psychiatry Res Neuroimaging. 2021;318:111393. doi:10.1016/j.pscychresns.2021.111393
Chidiac CW. An update on the medical consequences of anorexia nervosa. Curr Opin Pediatr. 2019;31(4):448-453. doi:10.1097/MOP.0000000000000755
Roberto CA, Mayer LE, Brickman AM, et al. Brain tissue volume changes following weight gain in adults with anorexia nervosa. Int J Eat Disord. 2011;44(5):406-411. doi:10.1002/eat.20840
Hsu LK, Crisp AH, Callender JS. Psychiatric diagnoses in recovered and unrecovered anorectics 22 years after onset of illness: a pilot study. Compr Psychiatry. 1992;33(2):123-127. doi:10.1016/0010-440x(92)90009-f
Boto J, Gkinis G, Roche A, et al. Evaluating anorexia-related brain atrophy using MP2RAGE-based morphometry. Eur Radiol. 2017;27(12):5064-5072. doi:10.1007/s00330-017-4914-9
Martin Monzon B, Hay P, Foroughi N, Touyz S. White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies. World J Psychiatry. 2016;6(1):177-186. Published 2016 Mar 22. doi:10.5498/wjp.v6.i1.177
Frieling H, Fischer J, Wilhelm J, et al. Microstructural abnormalities of the posterior thalamic radiation and the mediodorsal thalamic nuclei in females with anorexia nervosa--a voxel based diffusion tensor imaging (DTI) study. J Psychiatr Res. 2012;46(9):1237-1242. doi:10.1016/j.jpsychires.2012.06.005
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Przemysław Zaroda, Paweł Dąda, Paweł Pawlik, Patrycja Niewinna, Michał Żuchowski, Dominika Mańdziuk, Klaudia Kołodziej, Wojciech Kołodziej, Jakub Wawrzkowicz, Monika Korga
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 303
Number of citations: 0