Effect of body mass index and length of the disorder on hypoglycaemia in Anorexia Nervosa: continuous glucose monitoring in real-world settings
A. Pulini, M. Septier, C. Westphalen, O. Viltart, P. Gorwood, P. DuriezIntroduction
Anorexia nervosa (AN) often persists for years resulting in high morbidity and mortality rates. Hypoglycaemia, usually assessed from a single blood sample in the morning, is a critical severity indicator, continuous glucose monitoring (CGM) can therefore provide valuable data.
Objectives
This study aims to provide new glycaemic characteristics and look for their drivers, such as metabolic (present Body Mass Index, BMI) and duration of illness, in a sample of patients tested in real-world settings.
Methods
This cross-sectional study involved female outpatients with restricting subtype AN. Participants underwent CGM over 5 days in their usual environment. Data collected included age, BMI, illness duration, Eating Disorder Inventory-2 (EDI-2) scores. Glycaemic biomarkers such as hypoglycaemic area under the curve (AUC), mean and minimal glycaemia, and coefficient of variation were computed.
Results
Three hundred female patients were recorded for an average of 4.8 days. No significant correlation was found between glycaemic biomarkers and BMI. Illness duration significantly correlated with mean and minimum glycaemia (r = 0.26 and 0.23, respectively, p < 0.001) and hypoglycaemia AUC (r = -0.25, p < 0.001). Prolonged illness duration was associated with lower hypoglycaemia AUC and higher mean and minimal glycaemia.
Conclusions
In female patients with restricting subtype AN, illness duration rather than BMI may significantly impact glycaemic profiles. These results may suggest that glycaemic adaptations could be a factor that maintains undernutrition. AN should once more be conceptualized as a metabolic-psychiatric disorder.
Disclosure of Interest
None Declared