Letters

From the 1Department of Endocrinology, Hvidovre more positive responses) as per QEWP 2. Yanovski SZ, Nelson JE, Dubbert BK, University Hospital, Copenhagen, Denmark; and scoring criteria (based on DSM-IV) was Spitzer RL: Association of binge eating the 2Department of Endocrinology, Rigshospitalet, disorder and psychiatric comorbidity in University Hospital of Copenhagen, Copenhagen, 40% overall. When analyzed according to binge-eating status (present or absent), obese subjects. Am J Psychiatry 150:1472– Denmark. 1479, 1993 Address correspondence to Dr. Lene Ringholm subjects positive for binge eating were 3. Bruce B, Agras WS: Binge eating disorder: Nielsen, Department of Endocrinology, University younger (55.8 Ϯ 11.2 vs. 61.3 Ϯ 10.5 Hospital of Copenhagen Rigshospitalet, Blegdams- ϭ a population-based investigation. Int J Eat years, P 0.008), had a greater BMI Disord 12:365–373, 1992 vej 9, 2100 Copenhagen, Denmark. E-mail: Ϯ Ϯ 2 ϭ [email protected]. (36 6.6 vs. 33.6 5.8 kg/m , P 4. Wing RR, Marcus MD, Epstein LH, Blair DOI: 10.2337/dc06-1408 0.039), and had a higher A1C (8.2 Ϯ 2.2 EH, Burton LR: Binge eating in obese pa- © 2006 by the American Diabetes Association. vs. 7.3 Ϯ 1.8%, P ϭ 0.027) compared tients with type II diabetes. Int J Eat Disord with those with negative responses. Fur- 8:671–678, 1989 ●●●●●●●●●●●●●●●●●●●●●●● thermore, BES score, which assesses 5. Herpertz S, Albus C, Wagener R, Kocnar binge eating severity on a continuous M, Wagner R, Henning A, Best F, Foerster References H, Schulze Schleppinghoff B, Thomas W, 1. Evers IM, ter Braak EWMT, de Valk HW, scale, was significantly associated with A1C (r ϭ 0.24, P ϭ 0.021), BMI (r ϭ Kohle K, Mann K, Senf W: Comorbidity of van der Schoot B, Janssen N, Visser GHA: diabetes and eating disorders: does diabe- Risk indicators predictive for severe hypo- 0.36, P ϭ 0.001), and diastolic blood ϭ ϭ tes control reflect disturbed eating behav- glycemia during the first trimester of type pressure (r 0.22, P 0.018). BES ior? Diabetes Care 21:1110–1116, 1998 1 diabetic pregnancy. Diabetes Care 25: scores were higher in those with BDI 6. Celio AA, Wilfley DE, Crow SJ, Mitchell J, 554–559, 2002 scores Ն19 (suggestive of moderate to se- Walsh BT: A comparison of the binge eat- 2. Bode B, Gross K, Rikalo N, Schwartz S, vere depression), regardless of BMI and ing scale, questionnaire for eating and Wahl T, Page C, Gross T, Mastrototaro J: degree of glycemic control. Logistic re- weight patterns-revised, and eating disor- Alarms based on real-time sensor glucose gression analysis showed that age Ͻ60 der examination questionnaire with in- values alert patients to hypo- and hyper- years (odds ratio 3.4, P ϭ 0.018) and Af- structions with the eating disorder glycemia: the guardian continuous moni- ϭ examination in the assessment of binge toring system. Diabetes Technol Ther 6: rican-American ethnicity (6.20, P 0.004) were independently associated eating disorder and its symptoms. Int J Eat 105–113, 2004 Disord 36:434–444, 2004 with abnormal eating using the QEWP. The prevalence of binge-eating be- Prevalence and haviors appears to be elevated in over- Waist-to-Height weight patients with type 2 diabetes, Associations of Binge particularly when subjects are younger or Ratio and BMI Eating Disorder in a African American. Acknowledging the Predict Different Multiethnic limitations of questionnaires when com- Cardiovascular Risk pared with structured interviews, we sug- Population With gest using the QEWP as a quick screening Factors in Chinese Type 2 Diabetes tool to detect abnormal eating habits in Children patients with type 2 diabetes. Patients may then be referred to the appropriate inge eating disorder (BED) is a syn- health provider, who can implement ecently, waist-to-height ratio drome characterized by recurrent more comprehensive diagnostic evalua- (WHR) has been documented as a B uncontrollable overeating (1,2), tion and appropriate interventions (6). R better indicator of obesity and car- with prevalence rates of ϳ3% in the gen- diovascular risk than BMI in several dif- 1 eral population and 10- to 20-fold higher LUIGI F. MENEGHINI, MD, MBA ferent pediatric populations. In the 2 in patients seeking treatment for obesity JENNY SPADOLA, MPH present study, we, for the first time, com- 3 (1,3). There are limited reports of BED in HERMES FLOREZ, MD, MPH, PHD pared the association of nine cardiovascu- subjects with type 2 diabetes , particularly lar risk factors with BMI, waist From the 1Department of Medicine, Division of En- in minorities (4,5). docrinology, Diabetes, and Metabolism, University circumference (WC), and WHR in Chi- We conducted a pilot study to assess of Miami Miller School of Medicine, Miami, Florida; nese children. A random sample of 389 BED and its association with obesity, met- the 2Health Services Research Center, University of Han and 272 Uygur ethnic children aged abolic control, and depression in a tri- Miami and Humana, Miami, Florida; and the 7–18 years (mean Ϯ SE 10.7 Ϯ 3.2) were 3 ethnic (37% Hispanic, 40% non-Hispanic Health Services Research Center, University of Mi- selected stratified by age, sex, and ethnic- ami and Humana, and Miami Veterans Affairs Med- white, and 19% African American) popu- ical Center, Miami, Florida. ity from a school-based cross-sectional lation with type 2 diabetes (n ϭ 140). We Address correspondence to Luigi F. Meneghini, study performed in Xinjiang Uygur Au- used the nine-item Questionnaire of Eat- MD, MBA, 1450 NW 10 Ave., Miami, FL 33136. tonomous Region (the prevalence of obe- ing and Weight Patterns (QEWP), the E-mail: [email protected]. sity was 2.5 and 5.4% for Uygur and Han, DOI: 10.2337/dc06-1364 Binge Eating Scale (BES), and the Beck © 2006 by the American Diabetes Association. respectively). Uygur and Han are the two Depression Inventory (BDI) to assess our major ethnic groups in this region (45% study population. ●●●●●●●●●●●●●●●●●●●●●●● for each, 2003 national census). Ϯ On average, patients were (mean References Body weight, height, WC, systolic SD) 59.1 Ϯ 11.1 years old and had a mean blood pressure (SBP), dystolic blood 2 1. American Psychiatric Association: Diag- BMI of 34.5 Ϯ 6.2 kg/m , diabetes dura- nostic and Statistical Manual of Mental pressure (DBP), fasting serum triglycer- Ϯ tion of 10 7.8 years, and HbA1c (A1C) Disorders. 4th ed. Washington, DC, Amer- ide, total cholesterol, HDL, LDL, glucose, 7.7 Ϯ 2.0%. Abnormal eating (one or ican Psychiatric Association, 2000 and insulin were measured or determined

2760 DIABETES CARE, VOLUME 29, NUMBER 12, DECEMBER 2006