Letters P < 0.01). Higher HbA lc values were found in patients with clinical or subclin- ical eating disorders (8.5 ±1.9 vs. 7.2 ± 1.5, P < 0.05), and the difference was still significant after the elimination of patients who manipulated insulin doses. The routine assessment of eating attitudes should therefore be recom- mended in all IDDM women patients and in men with poor metabolic con- trol. EDOARDO MANNUCCI, MD VALDO RICCA, MD BARBARA MEZZANI, MD MILENA Di BERNARDO, MD FlORELLA PlANl, MD ROBERTO VANNINI, MD PIER LUIGI CABRAS, MD CARLO M. ROTELLA, MD From the Section of Metabolic Diseases and Diabetology, Division of Endocrinology, and the Psychiatric Unit, Department of Neuro- logic and Psychiatric Sciences, University of Florence, Italy. Address correspondence to Prof. Carlo M. Rotella, Section of Metabolic Diseases and Dia- betology, University of Florence, Viale Pierac- cini 6, 50134 Firenze, Italy. References 1. Hudson Jl, Wentworth SM, Hudson MS, Pope HG: Prevalence of anorexia nervosa and bulimia among young diabetic women. J Clin Psychiatry 46:88-89, 1985 2. Stancin T, Link DL: Binge eating and purging in young women with IDDM. Di- abetes Care 12:601-603, 1989 3. Birk R, Spencer ML: The prevalence of anorexia nervosa, bulimia, and induced glycosuria in IDDM females. Diabetes Educ 15:336-341, 1989 4. Fairburn CG, Peveler RC, Davies B, Mann JI, Mayou RA: Eating disorders in young adults with insulin-dependent diabetes mellitus: a controlled study. Br MedJ 303: 17-20,1991 5. Striegel-Moore RH, Nicholson TJ, Tam- borlane WV: Prevalence of eating disor- der symptoms in preadolescent and ado- lescent girls with IDDM. Diabetes Care 15: 1361-1368, 1992 6. Rodin G, Daneman D: Eating disorders and IDDM: a problematic association. Di- abetes Care 15:1402-1412, 1992 7. Wing RR, Nowalk MP, Marcus MD, Koeske R, Finegold D: Subclinical eating disorders and glycemic control in adoles- cents with type 1 diabetes. Diabetes Care 9:162-167, 1986 8. Steel JM, Young RJ, Lloyd GG, Mclntyre CCA: Abnormal eating attitudes in young insulin-dependent diabetics. BrJ Psychia- try 155:515-521, 1989 9. Rosmark B, Berne C, Holmgren S, Lago C, Renholm G, Sohlberg S: Eating disorders in patients with insulin-dependent diabe- tes mellitus. J C/in Psychiatry 47:547-550, 1986 10. Robertson P, Rosevinge JH: Insulin de- pendent diabetes mellitus: a risk factor for anorexia nervosa or bulimia nervosa? J Psychosom Res 32:535-541, 1990 11. Spitzer RL, Williams JBW, Gibbon M, First MB: Structured clinical interview for DSM-U1-R (SCID). Washington, DC, American Psychiatric Association, 1990 12. Hamilton M: A rating scale for depres- sion. JNeurol Neurosurg Psychiatry 23:56- 65,1960 13. Weissman MM, Bothwell S: Assessment of social adjustment by patient self-re- port. Arch Gen Psychiatry 33:1111-1115, 1976 14. American Psychiatric Association: Diag- nostic and Statistic Manual of Mental Disor- ders. 4th ed. Washington, DC, American Psychiatric Association, 1994 15. Henderson H, Freeman CPL: A self-rating scale for bulimia: the BITE. BrJ Psychiatry 150:18-24, 1987 16. Spielberg CD, Gorsuch RL, Lushene RE: Manual for the State-Trait Anxiety Inven- tory (self-evaluation questionnaire). Palo Alto, CA, Consulting Pychologists Press, 1970 17. DCCT Research Group: Reliability and validity of a diabetes quality of life mea- sure for the Diabetes Control and Com- plications Trial (DCCT). Diabetes Care 11: 725-732, 1988 Size of the Pancreas in Type I Diabetic Children and Adolescents F unctional and pathological studies on the pancreas have been per- formed in diabetic subjects (1,2). Autopsy findings have revealed a signifi- cant reduction of weight and size of the gland in patients with type I diabetes (3). The reasons why the destruction of /3-cells (which constitute only 2% of the gland) induces a significant reduction of the exocrine pancreatic tissue are not clarified. It has been shown that the exo- crine function of the pancreatic gland is impaired in diabetic subjects, and this deficit is closely related to the j3-cell dam- age (4). The paracrine trophic effect of in- sulin seems to be responsible for the re- duction of structure and size of the pancreatic gland (5,6). In the present study, ultrasonog- raphy of the pancreas was performed in 60 children and adolescents with type I diabetes randomly selected in a large group of diabetic patients participating in the study; their age ranged from 3-15 years. The patients were subdivided into three groups of 20 (10 boys, 10 girls) aged 3-7 years (group A), 8-12 years (group B), and 13-15 years (group C), respec- tivey. Diabetic patients were not receiving any drug except insulin. No child was suf- fering from a chronic disease other than diabetes. The control group consisted of 60 healthy subjects, sex- and age-matched, with no familiar history of type I or type II diabetes and pancreatic disease. They were selected among relatives of physi- cians and nurses in our hospital. Also, they were not receiving any drugs and were comparable with diabetic patients for height, weight, flanks, and waist cir- cumferences. Informed consent was ob- tained by the parents and children older than 10 years. In diabetic patients, dura- 1504 DIABETES CARE, VOLUME 18, NUMBER 11, NOVEMBER 1995 Downloaded from http://diabetesjournals.org/care/article-pdf/18/11/1504/443313/18-11-1504.pdf by guest on 19 September 2023