Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes

Abstract

Aims To assess the occurrence of disordered eating behaviours in teenagers with Type 1 diabetes and to compare characteristics according to level of disordered eating behaviours. Methods In this cross‐sectional study, we collected adolescents’ demographic and diabetes management data by parent–youth interview and chart review. Teenagers completed psychosocial surveys, including the Diabetes Eating Problem Survey‐Revised (DEPS‐R), a diabetes‐specific measure of disordered eating behaviours. We categorized teenagers according to level of disordered eating behaviours: low, DEPS‐R score <10; moderate, DEPS‐R score 10–19; and high, DEPS‐R score ≥20. Results The 178 teenagers (48% girls) were aged 14.9±1.3 years, with diabetes duration of 7.4±3.7 years. Most (59%) had low, 26% had moderate, and 15% had high levels of disordered eating behaviours. Several biomedical and psychosocial characteristics differed by level of disordered eating behaviours. There were more girls in the moderate (62%) and high (65%) than in the low level of disordered eating behaviours group (37%; P=0.003) and more obese teenagers in the moderate (13%) and high (27%) groups than in the low group (4%; P=0.0003). Frequency of daily blood glucose monitoring decreased (P=0.0006) and HbA1c level increased (P=0.01) with greater level of disordered eating behaviours. A greater level of disordered eating behaviours was also associated with poorer treatment adherence, more negative affect regarding blood glucose monitoring, poorer quality of life, and more depressive symptoms (all P<0.0001), along with more diabetes‐specific family conflict (P=0.01). Conclusions Identifying teenagers with Type 1 diabetes who have moderate and high levels of disordered eating behaviours may prevent progression to eating disorders and substantial morbidity by directing support and intervention efforts to those in need.

Instrument Context Relevance Evaluation, Translation, and Psychometric Testing of the Diabetes Eating Problem Survey-Revised (DEPS-R) among People with Type 1 Diabetes in China

“…Previous studies among youths and adults with T1D in different countries defined a score of DEPS-R ≥20 as an indicator of high risk for disordered eating behaviors [ 25 , 27 ]. The proportion of high risk of disordered eating behaviors in youths in this study (39.3%) is higher than adolescents with TID aged 13–17 in the United States (15.0%) [ 52 ] and Turkish children and adolescents aged 9–18 (25.0%) [ 29 ]. Nearly half of the adults (45.9%) had high risk of disordered eating behaviors, a higher rate than adults aged 18–28 in in the United States (22.0%).…”

Disturbed Eating Behaviors in Youth with Type 1 Diabetes: An Exploratory Study about Challenges in Diagnosis

“…These categories include a wide spectrum of eating behavior disturbances that must be closely evaluated such as selective eating, recurrent restrictive diets, binge eating, recurrent use of inappropriate compensatory behaviors to prevent weight gain, including fasting, excessive exercise, self-induced vomiting, misuse of laxative or diuretic, drinking excessive amounts of water or non-caloric beverages, mints, and gum [8][9][10][11][12][13][14].…”

Association of executive function problems and disordered eating behaviours in teens with type 1 diabetes

“…Executive function problems and disordered eating behaviours are two major challenges that can emerge during adolescence and potentially negatively impact self‐care behaviours and glycaemia 3,6,7,23 . In our sample of 169 teens with type 1 diabetes, executive function problems were more prevalent among those with moderate to high levels of disordered eating behaviours compared with those who had low level of disordered eating behaviours, suggesting important associations between executive function problems and disordered eating behaviours in teens with type 1 diabetes.…”

“…The validated cut‐off score of ≥20 indicates a high level of disordered eating behaviours and need for additional evaluation 22 . Scores from 10 to 19 have been described as a moderate level of disordered eating behaviours at which further assessment might be considered 23 …”