Naltrexone improves blood glucose control in type 1 diabetic women with severe and chronic eating disorders.

Abstract

Eating disorders are frequent causes of chronic failure of blood glucose control in young type 1 diabetic women (1) that result in a high incidence of diabetic complications (2). Moreover, severe disorders such as bulimia and binge eating are commonly associated with inappropriate compensatory behaviors to avoid weight gain, including self-induced vomiting, insulin misuse, laxative or diuretic surreptitious intake, and hyperactivity (3). Because these impulsive attitudes develop as addictions, naltrexone, an antagonist of endogenous opiates that is currently used to help weaning off alcohol, opiates, or heroin, might be considered a potentially effective therapy. Of note, recent data (4) report significant improvements obtained with naltrexone in bulimic patients, reinforcing the hypothesis of an opioid-mediated dependence. To assess the effectiveness of naltrexone in type 1 diabetic women presenting bulimia or binge eating, we conducted an open-label, 1-year pilot trial in 10 patients affected by these eating disorders who did not respond to antidepressive drugs, behavioral therapy, and interpersonal psychotherapy. All patients volunteered and gave their informed consent to enter the trial, which was ethically approved. Mean age of the patients was 22 …