Brief Screening Tool for Disordered Eating in Diabetes

Markowitz, Jessica T.; Butler, Deborah A.; Volkening, Lisa K.; Antisdel, Jeanne E.; Anderson, Barbara J.; Laffel, Lori

doi:10.2337/dc09-1890

Cited by 276 publications

(283 citation statements)

References 22 publications

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“…1,2,[25][26][27] Other studies involving individuals with T1D, however, have not found such differences.…”

Section: Discussionmentioning

confidence: 89%

“…Although other instruments specific to the investigation of risk behavior for ED in patients with T1D are available, none have been translated into Portuguese or validated for Brazil. [25][26][27] It bears noting that certain items of standardized tests, instead of representing risk behavior for ED, could rather be seen as indicating adequate control of diabetes. 9,33 This could be the case for EAT items such as ''I eat diet foods,'' ''I avoid foods with sugar in them,'' and ''I particularly avoid foods with a high carbohydrate content.''…”

Section: Limitationsmentioning

confidence: 99%

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Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Philippi

Cardoso

Koritar

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). Conclusions:Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.

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“…1,2,[25][26][27] Other studies involving individuals with T1D, however, have not found such differences.…”

Section: Discussionmentioning

confidence: 89%

Section: Limitationsmentioning

confidence: 99%

Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Philippi

Cardoso

Koritar

et al. 2013

Rev. Bras. Psiquiatr.

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“…The majority of the items on the DEPS-R were endorsed less frequently from baseline to the 1-month and 6-month follow-up assessments. Compared with a previous 11 sample of youth with T1D, 13-19 years old, baseline DEPS-R scores in this sample were slightly lower (median, 9.8 vs. 8.0), although the range was wider (range, 4.0-13.0 vs. 0-52.0). This may be due to the wider age range of the current sample (10-17 years) and their shorter diabetes duration compared with the earlier group.…”

Section: Eating Behaviors In Youth With T1dmentioning

confidence: 93%

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Markowitz

Alleyn²,

Phillips³

et al. 2013

Diabetes Technology & Therapeutics

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Background: There is risk for disordered eating behaviors in type 1 diabetes, especially related to insulin manipulation. Implementation of insulin pump therapy may encourage either normalization of eating behaviors or a greater focus on food intake due to renewed emphasis on carbohydrate counting. There is need for prospective studies to assess disordered eating behaviors upon implementation of pump therapy using diabetes-specific measurement tools. Subjects and Methods: In a multicenter pilot study, 43 youth with type 1 diabetes, 10-17 years old, were assessed prior to pump initiation and after 1 and 6 months of pump therapy. Youth completed the Diabetes-specific Eating Problems SurveyRevised (DEPS-R), a validated measure of risk for both diabetes-specific and general disordered eating behaviors. Results: Youth (45% female), 13.3 years old with diabetes for 2.1 years, had a mean hemoglobin A1c of 8.3 -1.3% (68 -14.5 mmol/mol) at baseline. DEPS-R scores decreased over time (P = 0.01). Overall rate of high risk for eating disorders was low. Overweight/obese youth endorsed more disordered eating behaviors than normal-weight participants. DEPS-R scores were correlated with z-score for body mass index at all three time points and with hemoglobin A1c after 1 and 6 months. Hemoglobin A1c did not change significantly over the 6 months and was higher in overweight/obese compared with normal-weight participants. Conclusions: Initiation of insulin pump therapy was associated with diminished endorsement of disordered eating behaviors in youth with type 1 diabetes. Longer follow-up studies are needed to assess the impact of insulin pump therapy on glycemic control, weight status, and disordered eating behaviors in this vulnerable population.

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“…Disordered eating behavior was assessed using the 16-item Diabetes Eating Problem Survey (DEPS-R) (Markowitz et al, 2010). The survey assesses behaviors such as skipping insulin or keeping blood sugars high to lose weight as well as feelings towards the relative priorities of losing weight and taking care of one’s diabetes.…”

Section: Methodsmentioning

confidence: 99%

Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus

Kahkoska

Watts

Driscoll³

et al. 2018

Obesity Medicine

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Aims No current clinical guidelines focus on weight management in youth with type 1 diabetes mellitus (T1DM). Our aim was to characterize the patient-perceived experience and barriers to weight management in youth with T1DM. Methods Participants were recruited from the University of North Carolina (n = 16, 56% female, 60% White, 50% insulin pump users, mean age 14.8 years, mean HbA1c 8.5% (69 mmol/mol)) and the University of Colorado (n = 18, 50% female, 80% white, 53% pump users, mean age 15.3 years, mean HbA1c 9.3% (78 mmol/mol)). Focus groups were stratified by sex and weight status (BMI cutoff = 25). Discussions were guided by a standardized set of questions, audio-taped, transcribed, and analyzed thematically using inductive qualitative methods. Results Youth with T1DM expressed four interrelated themes of antagonism between type 1 diabetes and weight management: dysregulated appetite, disruption of blood glucose levels associated with changing diet/exercise, hypoglycemia as a barrier to weight loss, and the overwhelming nature of dual management of weight and glycemic control, and two interrelated themes of synergism: improvement in shared, underlying heath behaviors and exercise as a tool for weight and glycemic control. Variation in emphasis of specific thematic elements was greatest across sex. Youth identified five major components of a weight management program for T1DM: intensified glucose management, healthy diet with known carbohydrate content, exercise, individualization and flexibility, and psychosocial and peer support. Conclusions There is critical need for personalized, T1DM-specific weight recommendations to overcome disease-specific barriers to weight management in the context of T1DM.

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Brief Screening Tool for Disordered Eating in Diabetes

Cited by 276 publications

References 22 publications

Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Disordered Eating Behaviors in Youth with Type 1 Diabetes: Prospective Pilot Assessment Following Initiation of Insulin Pump Therapy

Understanding antagonism and synergism: A qualitative assessment of weight management in youth with Type 1 diabetes mellitus

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