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LETTER TO THE EDITOR

Reply letter to the editor by Dr. Kawada Joana Nicolau1   · Juan Manuel Romerosa1 · Irene Rodríguez1 · Pilar Sanchís1 · Aina Bonet1 · Magdalena Arteaga1 · Regina Fortuny2 · Lluís Masmiquel1 Received: 16 July 2020 / Accepted: 17 July 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020

Dear Editor, We have received the letter/comment from Dr. Kawada about our article “Associations of food addiction with metabolic control, medical complications and depression among patients with type 2 diabetes” recently published on Acta Diabetologica [1]. All authors appreciate the comments and the additional information that complements the manuscript. In the letter, two main points were a matter of concern. The first was the difference in the prevalence of food addiction (FA) between our study and the one published by Yang et al. [2]. As we pointed out in the discussion, prevalence rates vary widely, from 8.6 to 70.2%. These changes appear to vary among ethnic subgroups, region and participants. If we specifically compare the population included in the mentioned article with our sample, many differences could explain these discrepancies in the prevalence of FA. Besides geographical and race disparities, patients included in our study were significantly older (63.8 ± 11.8 vs 48.27 ± 13.67 years) and mean diabetes duration was longer (12 ± 9.4 years vs patients newly diagnosed type 2 diabetes). Also, BMI was greater among subjects included in our study compared with the ones in the mentioned article, even when patients with diabetes did not meet criteria for FA (32.1 ± 6.5 Managed by Massimo Porta. This reply refers to the article available at https​://doi.org/10.1007/ s0059​2-020-01583​-9. * Joana Nicolau [email protected] 1



Endocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS) and Health Research Institute of Baleares (IdISBA), Ctra Manacor km 4, 07198 Palma de Mallorca, Baleares, Spain



Hormonal Laboratory, Hospital Son Llàtzer, Ctra Manacor km 4, 07198 Palma de Mallorca, Baleares, Spain

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vs 26.13 ± 3.79 kg/m2). The relationship between FA and increased BMI is well stablished, not only among people with T2DM, but also in the general population [1, 2]. Furthermore, Yang et al. ruled out FA by using the first version of the Yale Food Addiction Scale (YFAS), whereas we assessed the presence of FA by using the new version of the YFAS, the YFAS 2.0. As we pointed out in the methods section, in this new version of the YFAS, the threshold for meeting criteria for addictive eating lowered, similar to the threshold for meeting DSM-5 criteria for a substance use disorder [1]. We already commented on our limitations that it was not possible to generalize our results to other populations because all patients included were Caucasians [1]. The second comment was about a potential bidirectional relationship between diabetic retinopathy and psychiatric conditions. It is well known the association between type 2 diabetes (T2DM) a