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Niemelä PE, Leppänen HA, Voutilainen A, Möykkynen EM, Virtanen KA, Ruusunen AA, Rintamäki RM. Prevalence of eating disorder symptoms in people with insulin-dependent-diabetes: A systematic review and meta-analysis. Eat Behav 2024; 53:101863. [PMID: 38452627 DOI: 10.1016/j.eatbeh.2024.101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
AIMS To examine the prevalence of eating disorder symptoms (EDS) in 16 years and older individuals with insulin-dependent diabetes including both clinical and subclinical eating disorder symptoms. METHODS We searched PubMed, Embase, Scopus, PsycINFO, and CINAHL databases to discover studies reporting prevalence of eating disorder symptoms in patients with insulin-dependent diabetes (both type 1 and type 2). We performed a meta-analysis to estimate the pooled prevalence of eating disorder symptoms and an independent meta-analysis to estimate the prevalence of insulin omission. RESULTS A total of 45 studies were included in the meta-analysis of eating disorder symptoms. Diabetes Eating Problem Survey (DEPS-R) was the most frequently used screening tool (in 43 % of studies, n = 20). The pooled prevalence of eating disorder symptoms was 24 % (95 % CI 0.21-0.28), whereas in studies using DEPS-R, it was slightly higher, 27 % (95 % CI 0.24-0.31), with the prevalence ratio (PR) of 1.1. The prevalence differed between screening tools (χ2 = 85.83, df = 8, p < .0001). The sex distribution was associated with the observed prevalences; in studies with a higher female prevalence (>58 %), the pooled eating disorder symptom prevalence was higher [30 % (95 % CI 0.26-0.34) vs. 18 % (95 % Cl 0.14-0.22), PR 1.7]. The prevalence of insulin omission was 21 % (95 % CI 0.13-0.33). CONCLUSIONS Eating disorder symptoms and insulin omission are common in patients with insulin-dependent diabetes regardless of age. DEPS-R is the most used screening tool. Studies with a higher proportion of female participants report higher prevalence rates.
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Affiliation(s)
- Pia E Niemelä
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Puijonlaaksontie 2, 70210 Kuopio, Finland
| | - Hanna A Leppänen
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Puijonlaaksontie 2, 70210 Kuopio, Finland.
| | - Ari Voutilainen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland
| | - Essi M Möykkynen
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Puijonlaaksontie 2, 70210 Kuopio, Finland
| | - Kirsi A Virtanen
- Faculty of Medicine, Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Anu A Ruusunen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland; Department of Psychiatry, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland; IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Reeta M Rintamäki
- Department of Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Puijonlaaksontie 2, 70210 Kuopio, Finland
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South CA, Talbo MK, Roy-Fleming A, Peters TM, Nielsen DE, Iceta S, Brazeau AS. Does Insulin Delivery Technology Change Our Relationship with Foods? A Scoping Review. Diabetes Technol Ther 2024; 26:136-145. [PMID: 38032855 DOI: 10.1089/dia.2023.0382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Introduction: Automated insulin delivery (AID) systems reduce burden and improve glycemic management for people with type 1 diabetes (PwT1D) by automatically adjusting insulin as a response to measured glucose levels. There is a lack of evidence on AID and nutrition variables such as dietary intake, eating behaviors, and disordered eating. Objectives: This scoping review aims to provide a summary of the literature regarding AID and nutrition variables and to identify gaps that require further investigation. Methods: Two researchers conducted a blinded search of Medline (OVID) and PubMed for studies, including AID use (compared to non-AID use) and nutrition variables. Studies from January 2000 to July 2023 were included, as were PwT1D of all ages. Results: A total of 3132 articles were screened for appropriateness. After exclusions, 7 studies were included (2017-2023): 4 qualitative, 1 crossover, 1 randomized controlled, and 1 observational. Studies included adolescents (n = 1), adults (n = 3) or both (n = 2), and all ages (n = 1). In quantitative studies, AID was associated with lower eating distress (-0.43 ± 0.12, P = 0.004) and higher quality of life (3.1, 95% confidence interval [CI]: 0.8-5.4, P = 0.01), but not grams of carbohydrates at meals (1.0; 95% CI: -0.7 to 3.0; P = 0.24) and snacks (0.004; 95% CI: -0.8 to 0.8; P = 0.99) compared to non-AID use. In qualitative studies, AID increased the frequency and portions of food intake and led to less dietary control from parents. AID users reported eating foods higher in energy density. PwT1D were less worried about achieving accurate carbohydrate counting (CC) when using AID. Conclusions: AID use appears to influence eating behaviors, dietary patterns, and CC, although evidence was limited. AID may reduce food management burden due to the perception that AID can correct for CC inaccuracy. Significance: Further research needs to determine if AID allows for simplification of CC and improves eating behaviors while maintaining glycemic stability.
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Affiliation(s)
| | - Meryem K Talbo
- School of Human Nutrition, McGill University, Montreal, Canada
| | | | - Tricia M Peters
- Lady Davis Institute of Medical Research, Jewish General Hospital, Montreal, Canada
- Division of Endocrinology, Department of Medicine, The Jewish General Hospital, McGill University, Montreal, Canada
| | - Daiva E Nielsen
- School of Human Nutrition, McGill University, Montreal, Canada
| | - Sylvain Iceta
- Research Center of the Quebec Heart and Lung Institute, Quebec, Canada
- Department of Psychiatry and Neurosciences, Laval University, Quebec, Canada
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Elhabashy SA, Abd ElMalak MW, Elrassas HH, Thabet RA. Disordered eating and behaviors among young Egyptians with type 1 diabetes: risk factors and comorbidities. J Pediatr Endocrinol Metab 2022; 35:1385-1393. [PMID: 36127837 DOI: 10.1515/jpem-2022-0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The study aimed to assess occurrence of eating disorders and its nature, associated risk factors, and comorbidities in a cohort of adolescents with type 1 diabetes (T1D). METHODS In this cross-sectional study, 138 patients were recruited to complete three questionnaires for assessment of eating disorder (ED); Eating Attitude Test (EAT-26) and Eat Behavior questionnaire (ORTO-15) and Eating Disorder Examination Questionnaire version 6 (EDE-Q6) to assess diabetes-related medical outcomes. RESULTS Patients were categorized as having an ED according to predetermined cutoff value for each questionnaire. Of the 138 patients, 24 (17.4%) had risk for EDs by EAT-26 score, 53 (38.4%) have got orthorexia nervosa by ORTO-15 and 45 (32.6%) were having a disordered eating behavior by EDE-Q6. Patients with risk of EDs had lower mean ORTO-15 score (p=0.01), and higher mean Global EDE-Q6 (p<0.001). A positive correlation was found between EAT-26 scores and both age (p<0.0001) and body mass index (p<0.0001). ORTO-15 score was correlated with duration of diabetes (p=0.0418). Diabetic ketoacidosis, peripheral neuropathy, and microalbuminuria occurred frequently in patients with ED high score. Hypoglycemic episodes were reported more in those with high EAT-26 or Global EDE-Q6 scores. CONCLUSIONS Subclinical EDs and abnormal eating behaviors are common in Egyptian adolescents with T1D.
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Salah NY, Hashim MA, Abdeen MSE. Disordered eating behaviour in adolescents with type 1 diabetes on continuous subcutaneous insulin infusion; relation to body image, depression and glycemic control. J Eat Disord 2022; 10:46. [PMID: 35379350 PMCID: PMC8981863 DOI: 10.1186/s40337-022-00571-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/24/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Disordered eating behaviour (DEB) represents a significant morbidity among people with type-1 diabetes (T1D). Continuous-subcutaneous insulin infusion (CSII) improves glycemic control and psychological wellbeing in those with T1D. However, its relation to DEB remains obscure. OBJECTIVES To compare DEB among adolescents with T1D on CSII versus basal-bolus regimen and correlate it with body image, HbA1C and depression. METHODS Sixty adolescents with T1D (30 on CSII and 30 on basal-bolus regimen), aged 12-17 years were studied focusing on diabetes-duration, insulin therapy, exercise, socioeconomic standard, hypoglycemic attacks/week and family history of psychiatric illness. Anthropometric measures, HbA1C, binge eating scale (BES), body image tool, patient health questionnaire-9 (PHQ9) and the Mini-KID depression scale were assessed. RESULTS Among the studied adolescents with T1D, six had DEB (10%), 14 had poor body-image perception (23.3%), 42 had moderate body-image perception (70%) and 22 had depression (36.7%). Adolescents with T1D on CSII had significantly lower BES (p = 0.022), Mini-KID depression (p = 0.001) and PHQ9 (p = 0.02) than those on basal-bolus regimen. BES was positively correlated to depression (p < 0.001), HbA1C (p = 0.013) and diabetes-duration (p = 0.009) and negatively correlated to body-image (p = 0.003). CONCLUSION DEB is a prevalent comorbidity among adolescents with T1D, with higher frequency in those on basal-bolus regimen than CSII.
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Affiliation(s)
- Nouran Yousef Salah
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, 25 Korash Street, Nasr City, Cairo, Egypt.
| | - Mostafa Ahmad Hashim
- Department of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Karastogiannidou C, Giannoulaki P, Samaras I, Kotzakioulafi E, Didangelos T, Bocsan IC, Vassilopoulou E. The Diabetes Eating Problem Survey-Revised (DEPS-R) in a Greek Adult Population with Type 1 Diabetes Mellitus: Model Comparison Supporting a Single Factor Structure. Nutrients 2021; 13:nu13072375. [PMID: 34371885 PMCID: PMC8308548 DOI: 10.3390/nu13072375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/27/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) patients occasionally develop disordered eating behaviors, leading to insulin manipulation without medical consultation, targeting to achieve weight control. In clinical practice, the Diabetes Eating Problem Survey-Revised Version (DEPS-R) questionnaire has been used to evaluate eating disorders in T1DM patients. This study was conducted to validate the factor structure of the Greek version of DEPS-R using Confirmatory Factor Analysis (CFA), to investigate its reliability and convergent validity in Greek T1DM adults and to compare a single factor DEPS-R model with multiple factor models. Participants were 103 T1DM adults receiving insulin, who responded to DEPS-R. Their anthropometric, biochemical and clinical history data were evaluated. The sample presented good glycemic control and 30.1% scored above the established DEPS-R cut-off score for disturbed eating behavior. CFA results revealed that the data fit well to the factor models. The DEPS-R scale had good reliability and was positively linked to BMI, HbA1c, total daily dose and time in range. Model comparison supported the superiority of the 1-factor model, implying that Greek clinicians and practitioners might not have to consider individualized treatment based on various scores across different subscales but they can adopt a single DEPS-R score for an easy and efficient screening for disordered eating.
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Affiliation(s)
- Calliope Karastogiannidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
| | - Parthena Giannoulaki
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Ioannis Samaras
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
| | - Evangelia Kotzakioulafi
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Triantafyllos Didangelos
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania
- Correspondence:
| | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
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Troncone A, Chianese A, Zanfardino A, Cascella C, Piscopo A, Borriello A, Rollato S, Casaburo F, Testa V, Iafusco D. Disordered eating behaviors in youths with type 1 diabetes during COVID-19 lockdown: an exploratory study. J Eat Disord 2020; 8:76. [PMID: 33292623 PMCID: PMC7708884 DOI: 10.1186/s40337-020-00353-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recent research indicates that patients with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEBs) than their peers without diabetes. The present study aimed to explore the prevalence of DEBs in a sample of Italian children and adolescents with T1D and in matched-pair healthy controls during the COVID-19 lockdown. METHODS In a cross-sectional study, 138 children and adolescents with T1D (aged 8.01-19.11 years, 65 boys) attending a Southern Italian diabetic service and 276 age- and gender-matched healthy peers voluntarily completed an online survey about eating behaviors (ChEAT and EAT-26), anthropometric characteristics, and clinical characteristics. RESULTS 8.69% (N = 12) of participants with T1D and 13.4% (N = 37) of controls had ChEAT/EAT-26 scores indicating presence of DEBs, with no differences between patients-whether children (total ChEAT score F(1, 157) = .104, p = .748) or adolescents (total EAT-26 score F(1, 255) = .135, p = .731)-and healthy peers. zBMI values were lower than those measured in the latest diabetes visit (p < .0001), while HbA1c values remained unchanged (p = .110). In both groups, adolescents had lower Oral Control scores than children (T1D: F(1, 138) = 20.411, p < .0001, η2 = .132, controls: F(1, 276) = 18.271, p < .0001, η2 = .063); additionally, gender (female) and age were found to be significant predictors of several ChEAT/EAT-26 scores. CONCLUSIONS This exploratory study suggested that children and adolescents with T1D did not experience more DEB symptoms during the COVID-19 lockdown compared to healthy controls. Results revealed DEBs as more of a female adolescent developmental issue rather than a result of the challenges of living with a chronic illness under quarantine measures. Possible effects of parental pressure on their children's eating behaviors in the context of home confinement and of using a non-diabetes-specific measure to assess DEBs are discussed.
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Affiliation(s)
- Alda Troncone
- University of Campania "Luigi Vanvitelli", Caserta, Italy.
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy.
| | - Antonietta Chianese
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Crescenzo Cascella
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Alessia Piscopo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Anna Borriello
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Serena Rollato
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Francesca Casaburo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Veronica Testa
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Dario Iafusco
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
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Pursey KM, Hart M, Jenkins L, McEvoy M, Smart CE. Screening and identification of disordered eating in people with type 1 diabetes: A systematic review. J Diabetes Complications 2020; 34:107522. [PMID: 31928891 DOI: 10.1016/j.jdiacomp.2020.107522] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/12/2019] [Accepted: 12/31/2019] [Indexed: 12/18/2022]
Abstract
People with Type 1 diabetes (T1D) have been shown to be an at-risk group for the development of disordered eating behaviours, however, the validity of tools used to assess disordered eating behaviours in T1D is unclear. This review aimed to identify tools used to screen or identify disordered eating behaviours and eating disorders in people with T1D, and evaluate the validity and reliability of these tools. A systematic search strategy was conducted to October 2019 according to the PRISMA guidelines. The search strategy retrieved 2714 articles, with 100 articles describing 90 studies included in the review. Studies were predominantly conducted in adolescent females in clinical settings. Forty-eight individual tools were used across retrieved studies. Overall, the quality of tools reported in included articles was poor, with high risk of bias due to the use of non-validated tools (n = 44 articles) and few studies comparing to the reference standard (n = 10 articles) of a diagnostic interview. This review shows that a variety of tools have been used to screen and identify disordered eating behaviours and eating disorders in people with T1D. Future research including comparison to a gold standard diagnostic interview is warranted to further evaluate the validity and reliability of available tools.
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Affiliation(s)
- Kirrilly M Pursey
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia; Hunter New England Mental Health, Waratah, New South Wales 2298, Australia.
| | - Melissa Hart
- Hunter New England Mental Health, Waratah, New South Wales 2298, Australia; School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | - Laura Jenkins
- Hunter New England Mental Health, Waratah, New South Wales 2298, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | - Carmel E Smart
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia; Department of Paediatric Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, New South Wales 2303, Australia
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Pursey KM, Hay P, Bussey K, Trompeter N, Lonergan A, Pike KM, Mond J, Mitchison D. Diabetes and disordered eating behaviours in a community-based sample of Australian adolescents. J Eat Disord 2020; 8:5. [PMID: 32128205 PMCID: PMC7047351 DOI: 10.1186/s40337-020-0282-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND People with diabetes have been shown to be at risk for disordered eating compared to their non-diabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction. METHODS Secondary school students (n = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cut-offs for disordered eating behaviours were generated for analysis. RESULTS Disordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; p < 0.001), laxative use (diabetes 15.4%, no diabetes 2.1%; p < 0.001), use of cigarettes (diabetes 26.9%, no diabetes 4.3%; p < 0.001) and other drugs (diabetes 28.9%, no diabetes 4.0%; p < 0.001), cleanse/detox (diabetes 30.8%, no diabetes 10.5%; p < 0.001) and extreme weight loss diets (diabetes 13.5%, no diabetes 4.7%; p < 0.003) were higher in those reporting a diagnosis of diabetes. In addition, 17% of those with diabetes reported frequent insulin restriction (≥ once per week), and insulin restriction was associated with more frequent disordered eating behaviours. CONCLUSION There was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples.
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Affiliation(s)
- Kirrilly M Pursey
- 1Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 NSW Australia
| | - Phillipa Hay
- 2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.,Campbelltown and Camden Hospitals, Campbelltown, NSW Australia
| | - Kay Bussey
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Nora Trompeter
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Alexandra Lonergan
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Kathleen M Pike
- 5Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, NY USA
| | - Jonathon Mond
- 6Centre for Rural Health, University of Tasmania, Launceston, Australia.,7School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Deborah Mitchison
- 2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.,8Department of Psychology, Macquarie University, Sydney, NSW Australia
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Dias Santana D, Mitchison D, Gonzalez-Chica D, Touyz S, Stocks N, Appolinario JC, da Veiga GV, Hay P. Associations between self-reported diabetes mellitus, disordered eating behaviours, weight/shape overvaluation, and health-related quality of life. J Eat Disord 2019; 7:35. [PMID: 31695914 PMCID: PMC6824036 DOI: 10.1186/s40337-019-0266-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/02/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Eating disorders (ED) and disordered eating behaviours (DEB) have been found to be common in people with diabetes mellitus (DM). However, findings have been inconsistent. OBJECTIVE This study investigated the association between self-reported diabetes (Type 1 or 2) with ED/DEB (binge eating, subjective binge eating or loss of control overeating, severe dieting and purging) weight/shape overvaluation, and health-related quality of life (HRQoL) in a household survey in South Australia. METHOD In 2017 2977 people aged ≥15 years, who were representative of the general population, were interviewed. Participants reported their gender, age, household income, highest educational attainment, area of residence, presence of DM, ED/DEB, level of overvaluation, current HRQoL and height and weight. For the analyses between ED/DEB, self-reported DM and HRQoL, a grouping variable was created: 1) people without ED/DEB or self-reported DM; 2) people without ED/DEB and with self-reported DM; 3) people with ED/DEB and without self-reported DM; and 4) people with ED/DEB and self-reported DM. Analyses were stratified by sex and age group. RESULTS Subjective binge eating prevalence was higher in people with self-reported DM (6.6% vs 2.8%, p = 0.016), and overvaluation was lower in those with DM (36% vs 43.8%, p = 0.007). In analyses stratified by sex and age group, subjective binge eating was higher in women and in people over 45 years with self-reported DM and overvaluation was lower in men and in people over 45 years with self-reported DM. However, these differences were not significant on tests of gender and age interaction. People in both DM groups scored significantly lower than people without DM groups on physical HRQoL. In contrast, people in both ED/DEB groups scored lower than people without ED/BEB on mental HRQoL. CONCLUSION People with self-reported DM had a higher prevalence of subjective binge eating, a lower prevalence of overvaluation and there were no significant effects of age or gender. Furthermore, participants with self-reported DM and comorbid ED or DEB had impairments of both mental and physical HRQoL. Assessing an individual's sense of control over eating along with other DEB is likely important for identification of these mental health problems.
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Affiliation(s)
- Danilo Dias Santana
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, South Australia Australia
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, South Australia Australia
| | - Stephen Touyz
- School of Psychology, University of Sydney, Camperdown, NSW Australia
| | - Nigel Stocks
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, South Australia Australia
| | - Jose Carlos Appolinario
- Group of Obesity and Eating Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gloria Valeria da Veiga
- Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW Australia
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Cockroft MC, Bartlett TR, Wallace DC. Sleep, Nutrition, Disordered Eating, Problematic Tobacco and Alcohol Use, and Exercise in College Students With and Without Diabetes. J Psychosoc Nurs Ment Health Serv 2019; 57:23-32. [PMID: 31566702 DOI: 10.3928/02793695-20190919-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 07/22/2019] [Indexed: 01/29/2023]
Abstract
The purpose of the current study was to examine the health behaviors of college students with diabetes and compare behaviors to college students without diabetes. This descriptive study used the American College Health Association-National College Health Assessment II and included 1,216 students between ages 18 and 24. Health behaviors related to sleep, nutrition, disordered eating, problematic tobacco and alcohol use, and exercise were examined. Students with diabetes (n = 528) reported a higher frequency of meeting exercise recommendations and less healthy behaviors related to nutrition and problematic tobacco and alcohol use. Both groups of students reported inadequate sleep. Students with diabetes reported more academic problems due to sleep difficulties, disordered eating, and problematic alcohol use. Health behaviors in both groups showed similar needs for improvement. Nurses are in a position to guide new, prospective, and continuing college students with diabetes in practicing behaviors associated with positive health outcomes. Opportunities for interventions are numerous. [Journal of Psychosocial Nursing and Mental Health Services, 57(12), 23-32.].
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Troncone A, Cascella C, Chianese A, Zanfardino A, Confetto S, Piscopo A, Iafusco D. Parental assessment of disordered eating behaviors in their children with type 1 diabetes: A controlled study. J Psychosom Res 2019; 119:20-25. [PMID: 30947813 DOI: 10.1016/j.jpsychores.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The purpose of this research is to examine the presence of disordered eating behaviors (DEBs) in youths with type 1 diabetes (T1D) according to their parents' evaluations. The roles of demographic and diabetes-related variables were also analyzed. METHODS In 54 patients with T1D (aged 10.07-15.08) and in 54 age- and gender-matched healthy controls, DEBs were assessed using a parent-report standardized measure. BMI was calculated from height and weight. Glycemic control was assessed based on the most recent glycosylated hemoglobin value (HbA1c). The association of demographic and clinical factors with DEBs was evaluated through correlation and linear regression analyses. RESULTS DEBs were observed more frequently in participants with T1D (33.3%) than in controls (11%) (χ2 = 6.501, p = .04). The clinical sample obtained a higher score than controls in PEBEQ total score (t(106) = 2.464, p = .01), as well as in the Exaggerated interest in food (t(106) = 2.723, p = .008) and Rejection/disinterest in food subscales (t(106) = 2.216, p = .01). No gender differences were observed. In participants with T1D, but not in controls, PEBEQ total score was positively correlated with age (r = 0.203, p = .04), HbA1c (r = 0.335, p = .01), and zBMI (r = 0.298, p = .002); HbA1c (standardized beta =0.284, p = .04) was found to uniquely predict the PEBEQ total score. CONCLUSION Parents' evaluations may contribute to prompt detection of DEBs, which is crucial in developing appropriate strategies for timely intervention, especially during adolescence.
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Goebel-Fabbri A, Copeland P, Touyz S, Hay P. EDITORIAL: Eating disorders in diabetes: Discussion on issues relevant to type 1 diabetes and an overview of the Journal's special issue. J Eat Disord 2019; 7:27. [PMID: 31360517 PMCID: PMC6637645 DOI: 10.1186/s40337-019-0256-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/27/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Paul Copeland
- 2Endocrine Unit and MGH Weight Center, Massachusetts General Hospital, and Harvard Medical School, Boston, MA USA
| | - Stephen Touyz
- 3School of Psychology, Faculty of Science, the University of Sydney, Camperdown, New South Wales Australia.,4InsideOut Institute, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Phillipa Hay
- 5Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia
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