Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology

Wisting, Line; Reas, Deborah L.; Bang, Lasse; Skrivarhaug, Torild; Dahl‐Jørgensen, Knut; Rø, Øyvind

doi:10.1016/j.appet.2017.03.035

Cited by 37 publications

(32 citation statements)

References 47 publications

(55 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We speculate that the association of lower BMI z-scores with exposure to any adverse childhood experience among children with T1DM, could be caused by missing insulin doses, leading to poor glycemic control. Intentional insulin omission and eating disorder is quite prevalent among children with T1DM [23,24]. Isohookana et al also showed that out of 449 Finnish adolescents, those who had experienced an adverse event like sexual abuse, were at risk of developing extreme weight loss behaviors.…”

Section: Discussionmentioning

confidence: 99%

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Iqbal¹,

Kumar²,

Hansen³

et al. 2020

Children

View full text Add to dashboard Cite

Adverse childhood experiences (ACE) have been associated with a greater prevalence of risky behaviors and chronic health conditions, such as diabetes in adulthood. While adolescents with risk taking behaviors experience worsening of diabetic metabolic control, it is yet to be determined whether glycemic management in children and adolescents is negatively and independently influenced by ACEs. This study examines the relationship between ACEs in children and adolescents with type 1 diabetes (T1DM) and glycemic control, BMI and lipids. For such children, we hypothesized that hemoglobin A1c (HbA1c) is positively correlated with ACE scores. Parents of children (age 2–18 years) with T1DM completed a validated ACE questionnaire. The associations between parent and child ACE score and HbA1c, lipids and BMI z-scores were assessed using linear regression. The prevalence of any ACE was 27.9% among children and 49.0% among parents. HbA1c was significantly higher in children who had exposure to three or more ACEs (β:0.63 (4.5 mmol/mol); p = 0.02), in those who had a parent exposed to four or more ACEs (β:0.87 (7.2 mmol/mol); p = 0.03), in children who had exposure to household incarceration (β:0.62 (4.4 mmol/mol); p = 0.05) and children who witnessed or had been victim of violence in the neighborhood (β:0.71 (5.4 mmol/mol); p = 0.02). ACEs were highly prevalent among children with T1DM and had a positive association with glycemic control.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Iqbal¹,

Kumar²,

Hansen³

et al. 2020

Children

View full text Add to dashboard Cite

show abstract

“…This includes binge eating, dietary restriction and compensatory behaviors observed in the general population (e.g., self-induced vomiting) along with the unique capacity to restrict insulin for weight control. Studies show that disordered behaviors are associated with poor metabolic control and diabetes complications even when full diagnostic criteria for an eating disorder is not met (e.g., binge eating disorder, bulimia nervosa) [1, 3–5].…”

Section: Introductionmentioning

confidence: 99%

Real-time predictors and consequences of binge eating among adults with type 1 diabetes

et al. 2019

View full text Add to dashboard Cite

BackgroundObjective binge eating (OBE) is common among individuals with type 1 diabetes (T1D) and may have negative consequences for glycemic control. Recent studies have suggested that diabetes distress (i.e., emotional distress specific to diabetes and living with the burden of management) is a distinct emotional experience among individuals with diabetes. Preliminary studies have found diabetes distress is associated with eating disorder symptoms and poor glycemic control. The aim of the current study was to examine real-time emotional precursors and consequences of OBE in adults with T1D (i.e., general negative affect, specific emotional states and diabetes distress) using ecological momentary assessment methods. We also explore the impact of OBE on 2-h postprandial glycemic control relative to non-OBE eating episodes.MethodsAdults with T1D (N = 83) completed 3-days of ecological momentary assessment assessing mood and eating behavior using a telephone-based survey system. Participants were prompted to rate momentary affect, including level diabetes distress, at random intervals and reported on eating episodes. Participants also wore continuous glucose monitors allowing for ongoing assessment of glycemic control. Multi-level modeling was used to examine between- and within-person effects of momentary increases in emotions prior to eating on the likelihood of OBE and the impact of OBE on postprandial blood glucose. Generalized linear mixed models examined whether change in post-meal affect differed between OBE and non-OBE episodes.ResultsParticipants were predominately middle-aged (Mean = 42; SD = 12.43) Caucasian (87%) females (88%) reporting clinically significant eating disorder symptoms (76%). Nearly half of the sample (43%) reported OBE during the 3-day study period. The between-person effect for negative affect was significant (OR = 1.93, p < .05), indicating a 93% increased risk of OBE among individuals with higher negative affect compared to individuals with average negative affect. Between-person effects were also significant for guilt, frustration and diabetes distress (OR = 1.48–1.77, ps < .05). Analyses indicated that mean change in post-meal negative affect was significantly greater for OBE relative to non-OBE episodes (B = 0.44, p < .001). Blood glucose at 120 min postprandial was also higher for OBE than for non-OBE episodes (p = .03).ConclusionsFindings indicate that individuals who tend to experience negative affect and diabetes distress before eating are at increased risk of OBE at the upcoming meal. Results also suggest that engaging in binge eating may result in greater subsequent negative affect, including diabetes distress, and lead to elevated postprandial blood glucose levels. These findings add to a growing literature suggesting diabetes distress is related to eating disordered behaviors among individuals with T1D.

show abstract

“…In studies of meal frequency, conducted in individuals with type 1 diabetes, a meal pattern with smaller and more frequent meals have been associated with better glycaemic control 2–4 . Similarly, interventional trials in women with polycystic ovary syndrome 5 and in people with impaired glucose tolerance or overt type 2 diabetes 6 , comparing eating patterns with 3 and 6 daily meals have shown more favourable levels of glycaemia with higher meal frequencies.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, scheduling higher energy intake in the mornings, as compared with evenings, led to overall reduced glucose excursions throughout the day in type 2 diabetes 11 . While studies in type 1 diabetes are scarce, there is some evidence from adolescents with type 1 diabetes, that eating breakfast is associated with better glycaemic control 2 .…”

Section: Introductionmentioning

confidence: 99%

Meal timing, meal frequency, and breakfast skipping in adult individuals with type 1 diabetes – associations with glycaemic control

Ahola

Mutter

Forsblom

et al. 2019

Sci Rep

View full text Add to dashboard Cite

We assessed meal timing, meal frequency, and breakfast consumption habits of adult individuals with type 1 diabetes (n = 1007) taking part in the Finnish Diabetic Nephropathy Study, and studied whether they are associated with glycaemic control. Data on dietary intake and blood glucose measurements were retrieved from food records. HbA1c was measured at the study visit. In the whole sample, four peaks of energy intake emerged. Energy intake was the greatest in the evening, followed by midday. Altogether 7% of the participants reported no energy intake between 05:00 and 09:59 (breakfast skippers). While breakfast skippers reported lower number of meals, no difference was observed in the total energy intake between those eating and omitting breakfast. In a multivariable model, skipping breakfast was associated with higher mean blood glucose concentrations and lower odds of good glycaemic control. A median of 6 daily meals was reported. Adjusted for confounders, the number of meals was negatively associated with HbA1c, and the mean of the blood glucose measurements, but positively associated with the variability of these measurements. Our observations support the habit of a regular meal pattern, including consumption of breakfast and multiple smaller meals for good glycaemic control in adults with type 1 diabetes. However, an increase in the blood glucose variability may additionally be expected with an increase in the number of meals eaten.

show abstract

Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology

Cited by 37 publications

References 47 publications

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes

Real-time predictors and consequences of binge eating among adults with type 1 diabetes

Meal timing, meal frequency, and breakfast skipping in adult individuals with type 1 diabetes – associations with glycaemic control

Contact Info

Product

Resources

About