Anorexia Nervosa
Avoidant Restrictive Food Intake Disorder

Evaluation of Mean Plasma Glucose Levels Using HbA1C in Patients with Severe Eating Disorders

International Journal of Eating Disorders
By Leah Puckett, MD, MPH Philip S. Mehler, MD, FACP, FAED, CEDS

ABSTRACT

Objective: Hypoglycemia causes significant morbidity and mortality in patients with severe eating disorders. We measured average glycemic levels using hemoglobin A1C (HbA1C) in patients hospitalized for extreme anorexia nervosa (AN) and avoidant restrictive food intake disorder (ARFID).

Methods: This was a prospective, single-center cohort study conducted in an inpatient medical stabilization unit. Clinical outcomes were compared using paired t-tests. Additional analysis comparing clinical variables between undetectable and detectable HbA1c used two-sample t-tests.

Results: The study cohort consisted of 148 individuals, 90% female, average age of 31years, average admit body mass index of 12.5kg/m2, and mean percentage ideal body weight of 60.1%. Diagnoses included AN-restricting (54%), AN-binge purge (39%), and ARFID (7%). HbA1C and fructosamine levels decreased from admission to discharge. Serum glucose levels increased significantly from admission to discharge. Mean HbA1C was 4.7% on admission and 4.3% on discharge.

Discussion: This study evaluated mean blood glucose levels using HbA1C in patients with extreme forms of AN and ARFID. Given the concern for morbidity and mortality from hypoglycemia in this population, which can be overlooked on a single point-of-care glucose measurement, HbA1C is a valuable laboratory measure of glycemic status in patients with extreme forms of eating disorders

DOI:
https://doi.org/10.1002/eat.24285
Written by
Leah Puckett, MD, MPH

Leah Puckett, MD, MPH

Leah Puckett, MD, MPH, CEDS, has served as a Hospitalist at the ACUTE Center for Eating Disorders and Severe Malnutrition since 2018. She provides direct medical care to patients experiencing severe…
Written by
Philip S. Mehler, MD, FACP, FAED, CEDS

Philip S. Mehler, MD, FACP, FAED, CEDS

Philip S. Mehler, MD, FACP, FAED, CEDS, founded the ACUTE Center for Eating Disorders & Severe Malnutrition in 2001. He began his career at Denver Health more than 35 years ago and previously…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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