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 HbA_1c 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.

FIGURE 1

Distribution of Diabetes Eating Problem Survey-Revised (DEPS-R) scores by sex. More female than male participants had moderate (34% vs 19%) and high (20% vs 10%) levels of disordered eating behaviours (P=0.003).

FIGURE 2

Diabetes Eating Problem Survey-Revised (DEPS-R) scores in multivariate model by sex, weight status and HbA_1c. In a significant multivariate model, female sex (P=0.0004), obesity (P=0.047) and HbA_1c ≥75 mmol/mol (≥9.0%; P=0.046) were significantly associated with higher DEPS-R scores.