Eating-Disordered Behaviour in Adolescents with Type 1 Diabetes

Gonçalves, Sónia; Barros, Vânia Raquel Pereira de; Gomes, António Rui

doi:10.1016/j.jcjd.2015.09.011

Cited by 19 publications

(18 citation statements)

References 29 publications

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“…Some studies have found that increased BMI is associated with the onset of DE and persistence of DE behaviours over time . Others have demonstrated that increased BMI was not associated with DE; however, associations were found between negative attitudes about body shape and the desire to lose weight . Our findings support the idea that BMI‐Z scores are a less important predictor for DE among youth with T1D, and that clinical assessments should focus more on adolescents’ perceptions about their weight.…”

Section: Discussionsupporting

confidence: 76%

“…12,28 Others have demonstrated that increased BMI was not associated with DE; however, associations were found between negative attitudes about body shape and the desire to lose weight. 29 has only been observed in studies using diabetes adapted screening tools in comparison with those using screening tools for a general population. 4 We found that a higher HbA1c was an independent predictor of a positive DEPS-R screen and, therefore, more DE be- be interesting to see whether an interview-based assessment tool produces different prevalence rates.…”

Section: Discussionmentioning

confidence: 99%

“…DEPS scores of 8 [4-11.7], 16 [9][10][11][12][13][14][15][16][17][18][19][20][21][22] and 28 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36], respectively, as shown in Figure 2.…”

Section: Re Sultsmentioning

confidence: 99%

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Assessing the clinical utility of the diabetes eating problem survey‐revised (DEPS‐R) in adolescents with type 1 diabetes

Ryman

MacIsaac

Robinson

et al. 2019

Endocrino Diabet & Metabol

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Summary Objective Eating disorders are prevalent among adolescents with type 1 diabetes (T1D). We examined the clinical utility of the Diabetes Eating Problem Survey‐Revised (DEPS‐R), a brief self‐report questionnaire developed for patients with T1D, to identify at‐risk adolescents. We aimed to determine whether a positive DEPS‐R screen was predictive of a formal diagnosis of an eating disorder as per the DSM‐V. In addition, we assessed whether other variables including psychosocial characteristics and diabetes conflict were associated with an abnormal DEPS‐R screen. Methods Cross‐sectional study of 116 T1D adolescents aged 12‐17 years. All participants completed the DEPS‐R screening; both participants and parents completed a questionnaire addressing psychosocial characteristics/conflict around diabetes management. Clinical variables were obtained from participant charts. Differences were examined between positive and negative DEPS‐R groups. Adolescents who screened positive were offered a referral to a specialized eating disorder team for further assessment. Results From 116 participants (mean age ± SD = 14.6 years ± 1.56), 21% (24/116) scored positive for DEPS‐R More females than males had abnormal DEPS‐R (75% vs 25%, P = 0.001). Those with positive DEPS‐R score had higher HbA1c% (mean = 9.3 ± 1.3 vs 8.3 ± 1.2, P = 0.001). Positive DEPS‐R group had higher conflict score for diabetes management in both parents’ and children's assessments (both ps < 0.001). In regression analysis, being female (OR males = 0.07, 95%CI: 0.010‐0.46, P = 0.006), older (OR = 2.01, 95%CI: 1.16‐3.48, P = 0.040) and > child‐reported conflict (OR = 1.78, 95%CI: 1.02‐3.11, P = 0.044) were predictors of an abnormal DEPS‐R score. Conclusion The DEPS‐R score is a useful clinical tool for identifying T1D adolescents at risk for disordered eating behaviour, but has a low positive predictive value (PPV) for identifying adolescents who meet diagnostic criteria for an eating disorder. Female gender, suboptimal diabetes control and increased conflict in diabetes management are associated with an abnormal DEPS‐R score.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Assessing the clinical utility of the diabetes eating problem survey‐revised (DEPS‐R) in adolescents with type 1 diabetes

Ryman

MacIsaac

Robinson

et al. 2019

Endocrino Diabet & Metabol

View full text Add to dashboard Cite

show abstract

“…A Canadian study using the DSM-IV criteria found that subjects with diabetes had a higher prevalence of eating disorders (10%) when compared to non-diabetes controls (4%) (odds ratio 2.4, 95% CI 1.5 to 3.7; p < 0.001) [10]. Similar reports have been published from different TIDM populations across the world [13,14]. T1DM patients constitute a vulnerable population who have to consciously make the right choices at each meal to attain an acceptable degree of glycaemic control.…”

Section: Discussionsupporting

confidence: 53%

Type 1 diabetes mellitus and eating disorders

Joseph

Shyamasunder

Mammen

et al. 2016

Int J Diabetes Dev Ctries

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The choice of type and quantity of food is vital to achieving glycaemic control in diabetes, more so in type 1 diabetes mellitus. The attention to detail could however reach a level of obsession of an eating disorder and thereby have a negative impact on glycaemic control. We conducted a study to see if there was a risk of developing eating disorders among adolescent, young and middle-aged adults with type 1 diabetes mellitus and whether it has an association with HbA 1 C levels. A cross-sectional study was conducted on 113 type 1 diabetes mellitus patients and age-gender-matched healthy controls. The two groups were screened using the Eating Attitude Test-26 (EAT-26) questionnaire. EAT-26 identified type 1 diabetes as having a high risk for developing eating disorder when compared to those without diabetes (OR = 38.5 with 95% CI 8.7, 170.7; p < 0.001). The risk of developing eating disorder increased with the duration of diabetes. There was no significant difference in the risk between males and females. The risk of developing eating disorder did not correlate with glycaemic control. EAT-26 identified subjects with type 1 diabetes as high risk for developing eating disorder in comparison to those without diabetes. In our setting, this did not reflect on poor glycaemic control.

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“…Furthermore, BMI has not been found to be statistically different among those young adults with T1DM who report disordered eating and those who do not (40). Factors that predict eating disorders among adolescents with T1DM include desire for a lower weight, increased anxiety and lower diabetes related quality of life (41).…”

Section: Disordered Eating and Insulin Restrictionmentioning

confidence: 97%

Transition of care for patients with type 1 diabetes mellitus from pediatric to adult health care systems

2017

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Planning for the transition from pediatric to adult healthcare is broadly understood to be beneficial to the quality of care of patients with chronic illness. Due to the level of self-care that is necessary in the maintenance of most chronic diseases, it is important that pediatric settings can offer support during a time when adolescents are beginning to take more responsibility in all areas of their lives. Lack of supportive resources for adolescents with chronic conditions often results in both decreased access to care and impaired health and function likely leading to increased medical costs later. Additionally, fundamental differences in health care delivery exist between pediatric and adult care settings. There is limited empiric data and information on best practices in transition care. In this article we address the importance of bridging pediatric and adult care settings and highlight the challenges and successes of the implementation of the young adult transition clinic program for patients with type 1 diabetes at our facility. We provide recommendations for further research and program implementation with the transition population.

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Eating-Disordered Behaviour in Adolescents with Type 1 Diabetes

Cited by 19 publications

References 29 publications

Assessing the clinical utility of the diabetes eating problem survey‐revised (DEPS‐R) in adolescents with type 1 diabetes

Assessing the clinical utility of the diabetes eating problem survey‐revised (DEPS‐R) in adolescents with type 1 diabetes

Type 1 diabetes mellitus and eating disorders

Transition of care for patients with type 1 diabetes mellitus from pediatric to adult health care systems

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