Disordered Eating Behaviors in Emerging Adults With Type 1 Diabetes: A Common Problem for Both Men and Women

Doyle, Elizabeth A.; Quinn, Sheila; Ambrosino, Jodie M.; Weyman, Kate; Tamborlane, William V.; Jastreboff, Ania M.

doi:10.1016/j.pedhc.2016.10.004

Cited by 44 publications

(45 citation statements)

References 30 publications

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“…Our findings confirm recent studies that have reported associations between more disordered eating behaviours and female sex , higher BMI and poorer glycaemic control in people with Type 1 diabetes. In a recent large epidemiological study of 52 215 children and young adults with Type 1 diabetes, 467 individuals had an eating disorder according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders criteria .…”

Section: Discussionsupporting

confidence: 92%

“…Young people who scored ≥20 on the DEPS-R had higher BMI z-score (0.7 vs 0.2 standard deviation scores (SDS), P<0.001), higher HbA 1c (77 vs. 68 mmol/mol [9.2 vs. 8.4%], P<0.001), and were older (15.6 vs. 14.4 years, P<0.001) than young people who scored <20. In a study of 60 young adults with Type 1 diabetes [9], 23% scored ≥20 on the DEPS-R (30% of women vs 18% of men), a rate slightly higher than the present study (15%), which may be attributable to the difference in ages of the two samples. The young adults who scored ≥20 on the DEPS-R had higher HbA 1c (90 vs 62 mmol/mol [10.4 vs 7.8%]; P<0.001) and higher BMI (28.0 vs 25.4 kg/m 2 ; P=0.06) than those who scored <20.…”

Section: Discussioncontrasting

confidence: 90%

“…The prevalence of disordered eating behaviours in people with Type 1 diabetes ranges from 8% to 55%, depending on the definition and method of measurement [2,3,[6][7][8][9]. As in young people without Type 1 diabetes, disordered eating behaviours occur more frequently in girls and young women than in boys and young men [6,[8][9][10], more frequently in older than in younger adolescents [8,11], and in association with family conflict [7]. Insulin omission or restriction as a purging behaviour occurs in 11-30% of girls and women with Type 1 diabetes [3,5,[12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes

2019

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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 HbA1c 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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes

2019

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“…Therefore, further studies are required to investigate the reasons for the higher number of male adolescents with type 1 diabetes and DEB. DEB were also a typical feature of girls in our study, with a prevalence that was higher than some previous studies (Doyle et al, ; Saßmann et al, ; Wisting et al, ) but lower than the study reported by Araia et al ().…”

Section: Discussioncontrasting

confidence: 72%

Disordered eating behaviors in adolescents with type 1 diabetes: A cross‐sectional population‐based study in Italy

Cherubini

Skrami

Iannilli

et al. 2018

Intl J Eating Disorders

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“…Froisland, Skrivarhaug, Dahl-Jorgensen, & Ro, 2013a;Young et al, 2013). Although females with T1D are at high risk for developing an eating disorder (Gregg et al, 2015), data suggest comparable rates of DEBs among males and females with T1D (Baechle et al, 2014;Doyle et al, 2016). DEBs among individuals with T1D often include diseasespecific behaviors, most commonly intentional omission of insulin to avoid weight gain (Baechle et al, 2014;Colton et al, 2004).…”

mentioning

confidence: 99%

Test of the modified dual pathway model of eating disorders in individuals with type 1 diabetes

Rancourt

Foster

Bollepalli

et al. 2019

Intl J Eating Disorders

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Objective: Adolescents and young adults with type 1 diabetes (T1D) demonstrate high rates of disordered eating behaviors (DEBs) and may experience physiological and psychological vulnerabilities not currently included in established risk models of DEBs. This study examined associations among constructs included in the recently proposed T1D-specific modified dual pathway model and examined age as a moderator of these associations.Method: Participants included adolescents (n = 307; age M = 15.71, SD = 1.33), young adults (n = 313; age M = 21.20, SD = 2.10), and adults (n = 198; age M = 30.51, SD = 2.81) recruited via the T1D Exchange Clinic Registry. Data were collected from participants' medical records and from self-report questionnaires assessing dietary regimen, dietary restraint, body dissatisfaction, hunger/satiety, diabetes-specific negative affect, and DEBs. Multiple group path modeling was used to test hypotheses.Results: Approximately 31% of participants were at risk for an eating disorder. The original modified dual pathway model had poor model fit. The addition of three empirically defensible paths improved model fit. Diabetes-specific dietary regimen, diabetes-specific negative affect, and hunger/satiety disruption all were associated with DEBs. A fully varying multiple group model by age fit best; however, only the dietary restraint to DEBs pathway demonstrated a distinct pattern across age cohort, which attenuated from the adolescent to the adult cohort.Discussion: This study provides preliminary support for associations proposed in the modified dual pathway model and suggests potential for intervening on diseasespecific risk factors of DEBs in a T1D population. K E Y W O R D Sadolescent, eating disorder, hunger, type 1 diabetes, young adult

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Disordered Eating Behaviors in Emerging Adults With Type 1 Diabetes: A Common Problem for Both Men and Women

Cited by 44 publications

References 30 publications

Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes

Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes

Disordered eating behaviors in adolescents with type 1 diabetes: A cross‐sectional population‐based study in Italy

Test of the modified dual pathway model of eating disorders in individuals with type 1 diabetes

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