Aims: We examined the incidence of eating disorders (ED) in patients with type 2 diabetes and their impact on all-cause mortality, composite cardiovascular disease (CVD), cardiovascular (CV)-related mortality, and CV-related hospitalization.
Methods: This nationwide retrospective cohort study included 1,896,493 adults aged 20 years or older who underwent health examinations between 2013 and 2014. Time-varying Cox analyses were utilized to evaluate the effects of ED on all-cause mortality, composite CVD, CV-related mortality, and CV-related hospitalization in patients with type 2 diabetes.
Results: The type 2 diabetes group demonstrated an increased incidence of ED (adjusted hazard ratio [aHR], 1.20; 95% confidence interval [CI], 1.12–1.28) compared with the general population. Furthermore, the incidence of ED was higher among insulin users (aHR, 1.30; 95% CI, 1.09–1.54) than among non-insulin users (aHR, 1.18; 95% CI, 1.11–1.27). The type 2 diabetes with ED group showed an increased risk of all-cause mortality (aHR, 2.57; 95% CI, 2.30–2.87), composite CVD (aHR, 1.68; 95% CI, 1.44–1.96), CV-related mortality (aHR, 2.68; 95% CI, 1.94–3.70), and CV-related hospitalization (aHR, 1.61; 95% CI, 1.37–1.89).
Conclusion: Type 2 diabetes mellitus and ED increased all-cause mortality, composite CVD, CV-related mortality, and CV-related hospitalization. ED incidence was higher among insulin users with type 2 diabetes. Therefore, early diagnosis and personalized interventions are crucial to improve outcomes in this high-risk population.