Objective The aim of this study was to report nationwide data of the prevalence of disordered eating behaviors (DEBs) in adolescents with type 1 diabetes (T1D) and to evaluate a multidimensional model of eating problems, analyzing how psychopathological problems are associated with DEBs and with metabolic control. Methods This study was carried out using a cross-sectional design with a sample of 1,562 patients with T1D (812 male), aged 11–19 years. Participants were recruited from multiple pediatric diabetes centers (N = 30) located in northern, central, and southern Italy, and they individually completed the Diabetes Eating Problem Survey–Revised (DEPS-r) and the Youth Self-Report (YSR). Sociodemographic and clinical data were also gathered. Multiple-group structural equation modeling was used to investigate the relationships between internalizing/externalizing symptoms, DEBs, and glycosylated hemoglobin (HbA1c) values. Results A total of 29.7% of the participants reported DEBs (DEPS-r scores ≥20), 42.4% reported insulin manipulation (IM). The prevalence of DEBs was higher for female participants (p ≤ .001). The model explains 37% of the variance in disordered eating, 12% in IM, and 21% in HbA1c values. Body mass index, externalizing symptoms, and internalizing symptoms were significantly and positively associated with DEBs, which in turn were significantly and positively associated with HbA1c values (all p ≤ .001). Externalizing (p ≤ .001) and internalizing (p ≤ .01) symptoms were also directly associated with HbA1c values. Conclusion Given the relevant prevalence of DEBs, their significant positive association with psychopathological symptoms, and their relationship with worse diabetes outcomes, regular psychological screening and support is needed to ensure the best care of adolescents with T1D.

Background Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Psychopathology, alexithymia and uncertainty can be considered as clearly present in this population, and known to be harmful for the onset, maintenance and worsening of disorders. This study aimed to highlight the presence and directions assumed by these phenomena in subjects suffering from T1DM. Methods 105 subjects (F: 60%), aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included. To assess the presence of psychopathology, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, respectively, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample. Results A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Psychopathology appeared to be consistently represented in the sample, often overcoming pathological indexes. Alexithymia and uncertainty were common, highlighting their role in the light of the main pathology (T1DM). Continuity with current state of the art emerged, underlining the need for interventions. Conclusions Active psychopathology together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample. Adolescent subjects suffering from diabetes demonstrated its impact on psychological functioning while the results underlined some psychological phenomena possibly exacerbating general health status.