Depressive Symptoms, Emotion Dysregulation, and Bulimic Symptoms in Youth With Type 1 Diabetes

Abstract

This study evaluated the associations between depressive symptoms, emotion dysregulation and bulimic symptoms in youth with type 1 diabetes (T1D) in the context of the diagnosis and treatment of T1D. Study participants were 103 youth in 2 distinct groups: newly diagnosed (New) or transitioning to pump therapy (continuous subcutaneous insulin infusion [CSII]; "Pump"), who completed questionnaires regarding symptoms of depression, emotion dysregulation, and bulimia. Glycemic control (A1c), height, weight, and questionnaires were evaluated within 10 days of diagnosis (n = 58) or at education/clinic visit before starting insulin utilizing CSII (n = 45). In the newly diagnosed group, only depression accounted for significant variance in bulimia scores (β = .47, P < .01). For the group with disease treatment experience (Pump), but not for the newly diagnosed group (New), greater depressive symptoms and emotion dysregulation were associated with greater bulimic symptoms. Depressive symptoms and emotion dysregulation, an indicator of poor coping/behavioral control, could help explain adoption of disordered eating behaviors in youth with T1D who are transitioning to pump therapy.

Depressive Symptoms at Critical Times in Youth With Type 1 Diabetes: Following Type 1 Diabetes Diagnosis and Insulin Pump Initiation

“…This was a secondary analysis of a one-year observational prospective study conducted at 3 pediatric diabetes centers in the U.S. (23). A total of 103 youth ages 10–17 years were identified and recruited within 10 days of diagnosis of type 1 diabetes (n=58) or insulin pump therapy initiation (n=45).…”

A review of risk factors associated with insulin omission for weight loss in type 1 diabetes

“…Other prevalent causes of IO include injection anxiety, particularly in children ( Young-Hyman et al, 2016 ), and fear of hypoglycaemia (low blood sugar; Wild et al, 2007 ). Diabetes burnout, a state of exhaustion towards the condition associated with lack of treatment adherence and deficient blood glucose control ( Young-Hyman et al, 2016 ), may also result in omission of insulin.…”

“…Other prevalent causes of IO include injection anxiety, particularly in children ( Young-Hyman et al, 2016 ), and fear of hypoglycaemia (low blood sugar; Wild et al, 2007 ). Diabetes burnout, a state of exhaustion towards the condition associated with lack of treatment adherence and deficient blood glucose control ( Young-Hyman et al, 2016 ), may also result in omission of insulin. In this instance, people with T1D report feeling both physically and mentally tired of the constant need for self-care ( Abdoli et al, 2020 ) and are therefore unable to manage their diabetes control as adequately as is necessary.…”

Associations between disordered eating behaviour, diabetes distress and emotion regulation strategies in adults with type 1 diabetes: Results from a Dutch‐Italian cross‐sectional study

“…Kafali and colleagues 22 found that DEB was associated with experiencing difficulty accessing emotion regulation strategies and regulating one's emotions. Young-Hyman and colleagues 23 highlighted that the association between depressive symptoms and bulimic symptoms was moderated by emotion dysregulation, such that the interaction…”