Disordered Eating, Body Mass, and Glycemic Control in Adolescents With Type 1 Diabetes

Abstract

OBJECTIVE -To examine the relationship between disordered eating attitudes and behaviors, BMI, and glycemic control in adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODS -In a cross-sectional design, 152 adolescents (ages 11-19 years) completed three scales from the Eating Disorders Inventory (EDI): Body Dissatisfaction, Drive for Thinness, and Bulimia. All subjects had diabetes for Ͼ1 year. Glycemic control was assessed by glycosylated hemoglobin (HbA 1c ). Height and weight were measured to assess BMI.RESULTS -Adolescents with type 1 diabetes did not report more disordered eating attitudes and behaviors than the normative comparison sample. Male subjects with type 1 diabetes reported fewer symptoms of bulimia and female subjects with type 1 diabetes reported greater body satisfaction than the normative group. A higher BMI was a significant predictor of greater body dissatisfaction, more so for female than male subjects. Symptoms of bulimia were associated with older adolescence and female sex. Those with more symptoms of bulimia were also more likely to have a higher BMI. Sex (female) and body dissatisfaction (more dissatisfied) predicted a stronger desire to be thin. Longer duration of disease, more symptoms of bulimia, and obesity all predicted poorer glycemic control.

Comparison of Eating Pathology in Patients Diagnosed with Diabetes and Hypertension

“…Substantial fluctuations in blood glucose and insulin levels may cause changes in eating behavior, which has also been shown in several studies. [10][11][12][13][14] Without sufficient insulin, glucose has no ability to get into the cells to be used or to be stored in the cell, resulting in hyperglycemia and an increase in hunger. Likewise, exogenous insulin administration results in hunger along with an increased appetite, which is reflected in eating behavior changes.…”

“…The maximum possible score is 30 for Symptom Scale. A symptom score of 20 or more indicates the presence of binge eating; the medium range (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) suggests an unusual eating pattern; the low range (0-10) falls within normal limits. The BITE is a well-validated and reliable instrument: the inter-item reliability coefficient was 0.96 for the symptom subscale and the test-retest reliability was 0.86 and 0.68 for non-clinical and clinical groups, respectively.…”

“…10 Eating disorders, especially bulimia nervosa (BN) and disordered eating behaviors (DEB) have increased in the context of diabetes, although studies with conflicting results have been conducted. [10][11][12][13][14] Moreover, it has been shown that eating disorders and pathologic eating behaviors are related to elevated levels of HbA1c. 15 The diet in all chronic diseases is a matter of great importance.…”

Disordered Eating and Body Esteem Among Individuals with Glycogen Storage Disease

“…A study of healthy children (Bernier et al 2010) also demonstrated similar correlations between BMI percentile and overall body esteem (r ¼ À0.36 to À0.45, p < 0.01); however, those children demonstrated a negative correlation between BMI percentile and scores on the ChEAT (r ¼ À0.22 to À28, p < 0.01). When comparing to patients with chronic metabolic disease, previous research involving patients with Type I diabetes has noted that body dissatisfaction is associated with poor glycemic control, whereas good metabolic control is linked to better quality of life (Meltzer et al 2001;Hoey et al 2001). Poor metabolic control in GSD leads to greater complications and comorbid factors including hypoglycemic episodes, hepatomegaly, hyperlipidemia, hyperlactatemia, nephropathy, and hepatic adeno-mas, which may negatively impact quality of life.…”

Comportamentos de risco para transtornos alimentares em adolescentes e adultos portadores de diabetes tipo 1

“…Ensaios clínicos com adultos mostraram que insulinas de ação basal como a Detemir parecem causar menos ganho de peso do que a insulina NPH, em esquema com insulina de ação basal e insulina de ação ultra-rápida (HERMANSEN et al, 2004). E já se sabe que maior peso ou IMC podem ser preditores para risco de TA (Meltzer et al, 2001).…”