The impact of the COVID-19 lockdown on disordered eating behaviors in youths with type 1 diabetes: Analysis of cross-sectional survey data.

Abstract

Background: Recent research indicates that patients with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEBs) than their peers without diabetes. The present study aimed at examining the impact of the COVID-19 lockdown on DEBs in a sample of Italian children and adolescents with T1D and in matched-pair healthy controls.Methods: 138 children and adolescents with T1D (aged 8.01-19.11 years, 65 boys) attending a Southern Italian diabetic service and 276 age- and gender-matched healthy peers voluntarily completed a cross-sectional online survey of eating behaviors (ChEAT and Eat-26), anthropometric characteristics, and clinical characteristics. Results: 8.69% (N=12) of participants with T1D and 13.4% (N=37) of controls had ChEAT/EAT-26 scores indicating presence of DEBs, with no differences between patients—whether children (total ChEAT score F(1, 157)=.104, p=.748) or adolescents (total EAT-26 score F(1, 255)=.135, p=.731)—and healthy peers. zBMI values were lower than those measured in the latest diabetes visit (p<.0001), while HbA1c values remained unchanged (p=.110). In both groups, adolescents had lower Oral Control scores than children (T1D: F(1, 138)= 20.411, p<.0001, η2 =.132, controls: F(1, 276)=18.271, p<.0001, η2 =.063); additionally, gender (female) and age were found to be significant predictors of several ChEAT/EAT-26 scores.Discussion: Psychological conditions in relation to DEB symptoms of children and adolescents with T1D were not aggravated by lockdown conditions. Results indicated DEBs as more of a female adolescent developmental issue rather than as a result of the challenges of living with a chronic illness aggravated by outbreak. Possible effects of parental pressure on their children’s eating behaviors in the context of home confinement and of using a non-diabetes-specific measure to assess DEBs are discussed.