scholarly journals Disturbed Eating Behaviors in Youth with Type 1 Diabetes: An Exploratory Study about Challenges in Diagnosis

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1044
Author(s):  
Valeria Calcaterra ◽  
Chiara Mazzoni ◽  
Donatella Ballardini ◽  
Elena Tomba ◽  
Gian Vincenzo Zuccotti ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Early Recognition ◽  
Screening Tools ◽  
Effective Prevention ◽  
Eating Problem ◽  
R Factors

Background: Disordered eating behaviors (DEBs), including diagnosable eating disorders, are quite common and can interfere with optimal type 1 diabetes (T1DM) management. We explored DEBs prevalence in youth with T1DM, proposing news diagnostic subscales, to represent the clinical dimensions associated with feeding and eating disorders (ED); Methods: additionally to SCOFF questionnaire and Diabetes Eating Problem Survey–Revised (DEPS-R), four subscales combined from the original DEPS-R questionnaire were administered to 40 youths with T1DM (15.0 ± 2.6); Results: females showed higher scores than males in DEPS-R original factor 2 (“preoccupations with thinness/weight”, p = 0.024) and in DEPS-R proposed “restriction” factor (p = 0.009). SCOFF scores was correlated with original DEPS-R factors 1 (“maladaptive eating habits”) and 2 (p < 0.001) and with the newly proposed DEPS-R factors: restriction, disinhibition, compensatory behaviors, diabetes management (all p < 0.02). Diabetes management was the only factor related to glycated hemoglobin level (p = 0.006). Patients with high DEPS-R score (≥20) scored higher than patients with low (<20) DEPS-R score in DEPS-R original factors 1 (p < 0.001) and 2 (p = 0.002) as well as in the proposed factors including restriction, disinhibition, diabetes management (all p < 0.02); Conclusions: the complicated nature of DEBs calls for the development target specific questionnaires to be used as screening tools to detect cases of DEBs and exclude non cases. Early recognition of DEBs in adolescents with T1DM is essential for effective prevention and successful treatment.

Disordered Eating Behaviors in Youth With Type 1 Diabetes

2005 ◽  
Vol 31 (4) ◽  
pp. 572-583 ◽  
Author(s):  
Sarah Dion Kelly ◽  
Carol J. Howe ◽  
Jennifer Paige Hendler ◽  
Terri H. Lipman
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Disordered Eating ◽  
Eating Behaviors ◽  
Treatment Options ◽  
Screening Tools ◽  
Disordered Eating Behaviors ◽  
Chronic Hyperglycemia ◽  
Increased Risk

Eating disorders are a significant health problem for many adolescents and are described as occurring along a spectrum of symptoms including disordered eating behaviors and clinical eating disorders. Poor self-esteem and body image, intense fear of gaining weight or refusal to maintain weight, and purging unwanted calories are clinical features of some eating disorders. Type 1 diabetes is a chronic illness with marked insulin deficiency. Chronic hyperglycemia creates a state of glucosuria with subsequent weight loss. Diabetes treatment focuses on intensive daily management of blood glucose by balancing insulin, food intake, and physical activity. Insulin omission offers an easy method for the purging of unwanted calories. The combination of these 2 illnesses is potentially deadly and also leads to an increased risk of poor diabetes outcomes. This includes poor metabolic control (measured by elevated hemoglobin A1C), increased risk of diabetic ketoacidosis, and microvascular complications such as retinopathy and nephropathy. Diabetes clinicians should be aware of the potential warning signs in an adolescent with diabetes as well as assessment and treatment options for eating disorders with concomitant type 1 diabetes. This article reviews the available data on the prevalence, screening tools, assessment guidelines, and treatment options for eating disorders in youth with type 1 diabetes.

Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

2021 ◽  
Author(s):  
Ashley E. Tate ◽  
Shengxin Liu ◽  
Ruyue Zhang ◽  
Zeynep Yilmaz ◽  
Janne T. Larsen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Diagnosis ◽  
Disordered Eating Behaviors ◽  
Increased Risk ◽  
Clinical Diagnoses

OBJECTIVE <p>To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. </p> <p>RESEARCH DESIGN AND METHODS</p> <p>Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. </p> <p>RESULTS</p> <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> <p>CONCLUSION</p> <p>Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes. </p>

Eating Disorders and Type 1 Diabetes: a perspective

2021 ◽  
Vol 21 ◽  
Author(s):  
Simonetta Marucci ◽  
Giulia De Iaco ◽  
Giuseppe Lisco ◽  
Francesco Mariano ◽  
Vito Angelo Giagulli ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Management Strategy ◽  
Eating Behaviors ◽  
Psychosocial Issues ◽  
Disordered Eating Behaviors ◽  
Clinical Complexity ◽  
Poor Outcomes ◽  
The Relationship

: Patients with type 1 diabetes (T1D) are at risk of clinical eating disorders (EDs) and disordered eating behaviors (DEBs) than the general population. This burden is related mainly to diabetes-related physical and psychosocial issues especially beginning during childhood. DEBs must be investigated carefully and promptly managed in case of suspicion, as they can evolve into severe clinical EDs over time and are strictly related to poor outcomes. The significant number of scientific articles dealing with the relationship between T1D and DEBs or EDs confirms the complexity of these problems and the difficulties in diagnosis and treatment. This paper examined current scientific literature related to this topic, emphasizing the epidemiological and clinical complexity of the phenomenon and briefly summarizing EDBs management strategy in T1D patients.

Diabetes and Eating Disorders

2017 ◽  
pp. 221-234
Author(s):  
Liana Abascal ◽  
Ann Goebel-Fabbri
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Treatment Team ◽  
Disordered Eating Behaviors ◽  
Subclinical Eating Disorders ◽  
Treat Population

Rates of eating disorders are higher in patients with type 1 and type 2 diabetes than in the general population. Types of eating disorders include anorexia; bulimia; binge-eating disorder; subclinical eating disorders; and an eating disorder unique to type 1 diabetes, intentionally restricting insulin doses as a calorie purge—often referred to by laypeople as “diabulimia.” Women with diabetes and eating disorders (including disordered eating behaviors) have significantly elevated blood glucose ranges, higher rates of hospitalization, higher rates of diabetes complications, and, in some cases, higher mortality rates. This chapter discusses risk factors, presentation, and identification of eating disorders within the diabetes population. Specific recommendations are given for this difficult-to-treat population, including the need for an expanded treatment team as well as the need to establish mutually agreed upon and incremental diabetes management goals.

Clinical features of the diabetes eating problem survey–revised Turkish version in children and adolescent with type 1 diabetes

2020 ◽  
Vol 33 (10) ◽  
pp. 1307-1312
Author(s):  
Elif Sagsak ◽  
Asan Onder ◽  
Havva Nur Peltek Kendirci ◽  
Metin Yıldız ◽  
Derya Karaman Aksakal ◽  
...  
Keyword(s):  
At Risk ◽  
Type 1 Diabetes ◽  
Early Recognition ◽  
Child Psychiatrist ◽  
Turkish Version ◽  
Laboratory Findings ◽  
Adequate Treatment ◽  
Children And Adolescent ◽  
Eating Problem

AbstractObjectivesWe aim to delineate clinical characteristics that place individuals with type 1 diabetes (T1DM) at risk of developing eating problems by using Turkish version of diabetes eating problem survey-revised (DEPS-R).MethodsThe patients aged 9–18 years with T1DM who came to the pediatric endocrine outpatient clinic for control between February and December 2019 completed Turkish version of DEPS-R. Clinical and laboratory findings were obtained from patient files. Cases with a questionnaire score ≥20 were considered to be at risk for eating disorders (ED). Parents were informed when the results of the screening were positive, and were offered to child psychiatrist.ResultsThe median scores obtained with the Turkish version of DEPS-R for the total sample, for females and males were 15, 16, and 13 respectively. The score was significantly higher among females compared to males (p<0.001). DEPS‐R score positive group had higher age (mean [SD]=14.6 [2.7], p=0.009), BMI (mean [SD]=21.4 [3.2], p<0.001), HbA1c % (mean [SD]=9.37[2.3], p<0.001) and year of diabetes duration (mean [SD]=5.5 [3.6], p<0.001) compared to the negative group.ConclusionsEarly recognition and adequate treatment of ED in T1DM is essential. DEPS-R is sensitive in identifying young people with ED.

scholarly journals Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

2021 ◽  
Author(s):  
Ashley E. Tate ◽  
Shengxin Liu ◽  
Ruyue Zhang ◽  
Zeynep Yilmaz ◽  
Janne T. Larsen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Diagnosis ◽  
Disordered Eating Behaviors ◽  
Increased Risk ◽  
Clinical Diagnoses

OBJECTIVE <p>To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. </p> <p>RESEARCH DESIGN AND METHODS</p> <p>Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. </p> <p>RESULTS</p> <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> <p>CONCLUSION</p> <p>Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes. </p>

scholarly journals An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rhonda M. Merwin ◽  
Ashley A. Moskovich ◽  
Michael Babyak ◽  
Mark Feinglos ◽  
Lisa K. Honeycutt ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Acceptance And Commitment Therapy ◽  
Diabetes Management ◽  
Personal Values ◽  
Psychological Flexibility ◽  
Open Trial ◽  
Diabetes Distress ◽  
Acceptance And Commitment

Abstract Background Eating disorders (EDs) among individuals with type 1 diabetes (T1D) increase the risk of early and severe diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments have been largely ineffective for T1D patients, indicating the need to tailor treatments to this patient population and the unique conditions under which ED symptoms emerge (in the context of a chronic illness with unrelenting demands to control blood glucose, diet and exercise). The current study was a pilot open trial of iACT, a novel intervention for EDs in T1D grounded in Acceptance and Commitment Therapy (ACT). iACT was based on the premise that ED symptoms emerge as individuals attempt to cope with T1D and related emotional distress. iACT taught acceptance and mindfulness as an alternative to maladaptive avoidance and control, and leveraged personal values to increase willingness to engage in T1D management, even when it was upsetting (e.g., after overeating). A tailored mobile application (“app”) was used in between sessions to facilitate the application of ACT skills in the moment that individuals are making decisions about their diabetes management. Methods Adults with T1D who met criteria for an ED completed 12 sessions of iACT (with three optional tapering sessions). In addition to examining whether treatment was acceptable and feasible (the primary aim of the study), the study also examined whether iACT was associated with increased psychological flexibility (i.e., the ability to have distressing thoughts/feelings about diabetes while pursuing personally meaningful values), and improvements in ED symptoms, diabetes management and diabetes distress. Results Treatment was acceptable to T1D patients with EDs and feasible to implement. Participants reported increased psychological flexibility with diabetes-related thoughts/feelings, and less obstruction and greater progress in pursuing personal values. There were large effects for change in ED symptoms, diabetes self-management and diabetes distress from baseline to end-of-treatment (Cohen’s d = .90–1.79). Hemoglobin A1c also improved, but the p-value did not reach statistical significance, p = .08. Conclusions Findings provide preliminary evidence for iACT to improve outcomes for T1D patients with EDs and support further evaluation of this approach in a controlled trial. Trial registration NCT02980627. Registered 8 July 2016.

Translation and validation of the Diabetes Eating Problem Survey to screen eating disorders in patients with type-1 diabetes mellitus

2017 ◽  
Vol 148 (12) ◽  
pp. 548-554
Author(s):  
Cintia Sancanuto ◽  
Diana Jiménez-Rodríguez ◽  
Francisco Javier Tébar ◽  
Juan José Hernández-Morante
Keyword(s):  
Diabetes Mellitus ◽  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Eating Problem ◽  
Translation And Validation

scholarly journals Instrument Context Relevance Evaluation, Translation, and Psychometric Testing of the Diabetes Eating Problem Survey-Revised (DEPS-R) among People with Type 1 Diabetes in China

2021 ◽  
Vol 18 (7) ◽  
pp. 3450
Author(s):  
Wencong Lv ◽  
Qinyi Zhong ◽  
Jia Guo ◽  
Jiaxin Luo ◽  
Jane Dixon ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Disordered Eating ◽  
Convergent Validity ◽  
Eating Behaviors ◽  
Psychometric Testing ◽  
Disordered Eating Behaviors ◽  
Eating Problem ◽  
Relevance Evaluation ◽  
Relevance Index

Background: People with type 1 diabetes are susceptible to disordered eating behaviors. The American Diabetes Association recommends using the Diabetes Eating Problem Survey-Revised (DEPS-R) to screen them. There is no validated diabetes-specific screening measure in China. The objectives were to adapt DEPS-R into Mandarin Chinese and to test its psychometric properties among youths and adults with type 1 diabetes in China, respectively. Methods: This study was conducted in two phases. Phase 1 included context relevance evaluation and instrument translation. Phase 2 was psychometric testing of reliability and construct validity among 89 youths (8~17 years old) and 61 adults with type 1 diabetes. Result: The Context Relevance Index and Translation Validity Index of this instrument were good. Strong internal consistency reliability correlations and convergent validity were demonstrated among youths and adults. Discussion: The Chinese version of the DEPS-R is a valid and reliable tool for screening disordered eating behaviors in Chinese youths and adults with type 1 diabetes. The Context Relevance Index is advocated to evaluate the difference between the context in which an instrument was originally developed and the target context.

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