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Engström L. Controlling the Diabetic Body? Managing Chronic Illness with Wearable Technology. Med Anthropol 2024:1-16. [PMID: 39072586 DOI: 10.1080/01459740.2024.2384749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
I explore the experience of managing type 1 diabetes with wearable technology. Type 1 diabetes is a chronic illness which requires continuous maintenance to keep the blood glucose levels within range. Using autoethnography, I investigate both the practices of translating information from technology and from senses, and also from health authorities, into practices. I conclude that the management of type 1 diabetes is informed by an urge to control the body, but this situation can be understood otherwise from a logic of care.
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Affiliation(s)
- Lisa Engström
- Department of Arts and Cultural Sciences, Lund University, Lund, Sweden
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2
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Marks KP, Aalders J, Liu S, Broadley M, Thastum M, Jensen MB, Ibfelt EH, Birkebaek NH, Pouwer F. Associations between Disordered Eating Behaviors and HbA 1c in Young People with Type 1 Diabetes: A Systematic Review and Meta-analysis. Curr Diabetes Rev 2024; 20:e220823220144. [PMID: 37608674 DOI: 10.2174/1573399820666230822095939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/25/2023] [Accepted: 07/03/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND In type 1 diabetes, disordered eating behaviors (DEB) can adversely impact HbA1c. Diabetes-adapted DEB questionnaires assess intentional insulin omission, whereas generic questionnaires do not. Given the number of studies describing DEB-HbA1c associations published over the past decade, an updated systematic review is warranted. OBJECTIVE The study aimed to examine the associations between DEBs assessed by generic and diabetes- adapted questionnaires (and subscales) and HbA1c among young people (<29 years) with type 1 diabetes. METHODS A systematic search was conducted in PubMed, Embase, PsycInfo, and CINAHL databases. Observational studies examining associations between DEB as assessed by questionnaires and HbA1c were included. Publication information, DEB and HbA1c characteristics, and DEBHbA1c associations were extracted. Hedges' g was calculated for mean HbA1c differences between groups with and without DEB. RESULTS The systematic search yielded 733 reports, of which 39 reports representing 35 unique studies met the inclusion criteria. Nineteen studies assessing DEB by diabetes-adapted questionnaires (n=5,795) and seven using generic questionnaires (n=2,162) provided data for meta-analysis. For diabetes-adapted questionnaires, DEB was associated with higher HbA1c (g=0.62 CI=0.52; 0.73) with a similar effect size when restricted to validated questionnaires (g=0.61; CI=0.50; 0.73). DEB was not associated with HbA1c for generic questionnaires (g=0.19; CI=-0.17; 0.55), but significantly associated with higher HbA1c for validated generic questionnaires (g=0.32; 95% CI=0.16-0.48). Participant and HbA1c collection characteristics were often inadequately described. CONCLUSION Diabetes-adapted DEB questionnaires should be used in youth with type 1 diabetes because they capture intentional insulin omission and are more strongly associated with HbA1c than generic DEB questionnaires.
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Affiliation(s)
- Kevin P Marks
- Department of Clinical Medicine - Paediatrics, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jori Aalders
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Melanie Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Else Helene Ibfelt
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
| | - Niels H Birkebaek
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, The Netherlands
- Steno Diabetes Center Odense, Odense, Denmark
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3
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Yahya AS, Khawaja S, Naguib M. ‘Diabulimia’: current insights into type 1 diabetes and bulimia nervosa. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2023. [DOI: 10.1002/pnp.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Ahmed Saeed Yahya
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
| | - Shakil Khawaja
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
| | - Meena Naguib
- Dr Yahya is a Consultant Psychiatrist at both the Priory Hospital North London and The Maudsley Hospital in South London; Dr Khawaja is a Consultant Psychiatrist and ECT Clinical Lead, and Dr Naguib is a Locum Consultant Psychiatrist, both at North East London NHS Foundation Trust
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4
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Oldham-Cooper R, Semple C. Prevention and early help for eating disorders in young people with type 1 diabetes. Clin Child Psychol Psychiatry 2021; 26:656-668. [PMID: 33601920 DOI: 10.1177/1359104521994172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
There is building evidence that early intervention is key to improving outcomes in eating disorders, whereas a 'watch and wait' approach that has been commonplace among GPs and other healthcare professionals is now strongly discouraged. Eating disorders occur at approximately twice the rate in individuals with type 1 diabetes compared to the general population. In this group, standard eating disorder treatments have poorer outcomes, and eating disorders result in a particularly high burden of morbidity. Therefore, our first priority must be prevention, with early intervention where disordered eating has already developed. Clinicians working in both eating disorders and diabetes specialist services have highlighted the need for multidisciplinary team collaboration and specific training, as well as improved treatments. We review the current evidence and future directions for prevention, identification and early intervention for eating disorders in children and young people with type 1 diabetes.
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Affiliation(s)
- Rosie Oldham-Cooper
- Psychological Health Service, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Royal Hospital for Children, UK.,School of Psychological Science, University of Bristol, UK
| | - Claire Semple
- Psychological Health Service, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Royal Hospital for Children, UK
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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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6
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Conviser JH, Fisher SD, McColley SA. Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review. Int J Eat Disord 2018; 51:187-213. [PMID: 29469935 DOI: 10.1002/eat.22831] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Pediatric chronic illnesses (CI) can affect a child's mental health. Chronic illnesses with treatment regimens that specify a therapeutic diet may place the child at increased risk for disordered eating and specific eating disorders (ED). The aim of this review is to examine the relation between diet-treated CI and disordered eating and to determine the order of onset to infer directionality. Diet-treated CI is hypothesized to precede and to be associated with disordered eating. METHOD A comprehensive search of empirical articles that examine the relation between diet-treated CI (diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and inflammatory bowel diseases) and disordered eating was conducted in Medline and PsycINFO using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A table of the sample's characteristics, ED measures, major pertinent findings, and the onset of CI in relation to ED were provided. RESULTS Diet-treated CI was associated with disordered eating and ED. Diet-treated CI had onset prior to disordered eating in most studies, except for inflammatory bowel diseases. Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes. DISCUSSION Interventions for diet-treated CI require a focus on diet and weight, but may increase the risk for disordered eating. Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers.
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Affiliation(s)
- Jenny H Conviser
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E Ontario St, Chicago, Illinois, 60611
| | - Sheehan D Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E Ontario St, Chicago, Illinois, 60611
| | - Susanna A McColley
- Department of Pediatrics, Division of Pulmonary Medicine, Northwestern University Feinberg School of Medicine, 420 E. Superior Street, Chicago, Illinois, 60611
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Clery P, Stahl D, Ismail K, Treasure J, Kan C. Systematic review and meta-analysis of the efficacy of interventions for people with Type 1 diabetes mellitus and disordered eating. Diabet Med 2017; 34:1667-1675. [PMID: 28887815 DOI: 10.1111/dme.13509] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 01/07/2023]
Abstract
AIM To examine the types of interventions currently available for people with Type 1 diabetes mellitus and their effectiveness. BACKGROUND The prevalence of disordered eating in people with Type 1 diabetes mellitus is twice that in their counterparts without diabetes, and is associated with worse biomedical outcomes and greater mortality. METHODS Medline, Embase, PsycINFO, the Cochrane Library, PubMed and OpenGrey databases were searched up to August 2016 to identify studies on interventions in people with Type 1 diabetes-associated disordered eating. For the systematic review, intervention components were identified and their effectiveness was examined. For the meta-analysis, the pooled effect sizes of glycaemic control (HbA1c ) between pre- and post-treatment in treatment and comparison groups were calculated using a random effects model. RESULTS Of 91 abstracts reviewed, six studies met the inclusion criteria, of which three had appropriate data for the meta-analysis (n = 118). The pooled effect size was -0.21 95% CI (-0.58 to 0.16; where negative values represent an improvement in HbA1c levels), indicating no statistically significant improvement in the treatment group compared with comparison group. Inpatient therapy appeared to be the most effective treatment, and this had multiple components including cognitive behavioural therapy, psychoeducation and family therapy. CONCLUSION Limited or no improvement in glycaemic control and disordered eating symptoms was observed in people with Type 1 diabetes-associated disordered eating who were receiving currently available interventions. The present review suggests that developing an intensive intervention with a joint focus on both disordered eating and diabetes management is needed for this complex patient group.
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Affiliation(s)
- P Clery
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Stahl
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K Ismail
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Kan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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8
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Eilander MMA, de Wit M, Rotteveel J, Aanstoot HJ, Waarde WMBV, Houdijk ECAM, Luman M, Nuboer R, Oosterlaan J, Winterdijk P, Snoek FJ. Diabetes IN develOpment (DINO): the bio-psychosocial, family functioning and parental well-being of youth with type 1 diabetes: a longitudinal cohort study design. BMC Pediatr 2015; 15:82. [PMID: 26173476 PMCID: PMC4502615 DOI: 10.1186/s12887-015-0400-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 07/02/2015] [Indexed: 02/08/2023] Open
Abstract
Background Strict glycemic control during adolescence decreases the risk of developing complications later in life, even if this level of control is not maintained afterwards. However, the majority of adolescents with type 1 diabetes (T1D) are in poor control and so far medical or psychological interventions have shown limited success. Adolescence is characterized by major biological, psychosocial, cognitive and parent–child relationship changes and the complex interaction between these developmental trajectories, and its impact on health outcomes is still poorly understood. A specific topic of interest in this context is the timing of diagnosis. The longitudinal study DINO (Diabetes IN develOpment) aims to examine:If and how the onset of T1D before vs. during puberty results in different outcomes of glycemic control, self-management, psychological functioning and diabetes-related quality of life. The timing of onset of disturbed eating behavior, its risk factors and its prospective course in relation to glycemic and psychological consequences. If and how the onset of T1D before vs. during puberty results in different family functioning and parental well-being. If and how the cognitive development of youth with T1D relates to glycemic control and diabetes self-management.
Methods/design DINO, a longitudinal multi-center cohort study is conducted in youth with T1D in the age range 8–15 years at baseline. Participants will be divided into two subgroups: pre-pubertal and pubertal. Both groups will be followed for 3 years with assessments based on a bio-psychosocial model of diabetes, scheduled at baseline, 12 months, 24 months and 36 months examining the biological, psychosocial -including disturbed eating behaviors- and cognitive development, family functioning and parental well-being. Discussion A better understanding of how the different trajectories affect one another will help to gain insight in the protective and risk factors for glycemic outcomes and in who needs which support at what moment in time. First results are expected in 2016. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0400-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Minke M A Eilander
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081, HV, Amsterdam, The Netherlands. .,EMGO+Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Maartje de Wit
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081, HV, Amsterdam, The Netherlands. .,EMGO+Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Joost Rotteveel
- EMGO+Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands. .,Department of Pediatrics, VU Medical Center, De Boelelaan 1118, 1081, HV, Amsterdam, The Netherlands.
| | - Henk Jan Aanstoot
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Blaak 6, 3011, TA, Rotterdam, The Netherlands.
| | - Willie M Bakker-van Waarde
- Department Pediatrics, University Hospital of Groningen, Hanzeplein 1, 9700, RB, Groningen, The Netherlands.
| | - Euphemia C A M Houdijk
- Department of Pediatrics, Haga Hospital Juliana Children's Hospital, Sportlaan 600, 2566, MJ, the Hague, The Netherlands.
| | - Marjolein Luman
- Department Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands.
| | - Roos Nuboer
- Department of Pediatrics, Meander Medical Centre, Maatweg 3, 3813, TZ, Amersfoort, The Netherlands.
| | - Jaap Oosterlaan
- Department Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands.
| | - Per Winterdijk
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Blaak 6, 3011, TA, Rotterdam, The Netherlands.
| | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Center, De Boelenlaan 1117, 1081, HV, Amsterdam, The Netherlands. .,EMGO+Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands. .,Department of Medical Psychology, Academic Medical Center (AMC), Meibergdreef 9, 1100, DD, Amsterdam, The Netherlands.
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Young V, Eiser C, Johnson B, Brierley S, Epton T, Elliott J, Heller S. Eating problems in adolescents with Type 1 diabetes: a systematic review with meta-analysis. Diabet Med 2013; 30:189-98. [PMID: 22913589 DOI: 10.1111/j.1464-5491.2012.03771.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIMS We report a systematic review to determine (1) prevalence of eating problems compared with peers and (2) the association between eating problems and glycaemic control in young adults with Type 1 diabetes. METHOD We conducted a systematic literature search via electronic databases and meta-analysis. Cohen's d (the mean difference score between Type 1 diabetes and comparison groups) was calculated for 13 studies that met inclusion criteria. RESULTS Eating problems [both disordered eating behaviour (39.3 and 32.5%; d = 0.52, 95% CI 0.10-0.94) and eating disorders (7.0 and 2.8%; d = 0.46, 95% CI 0.10-0.81)] were more common in adolescents with Type 1 diabetes compared with peers and both were associated with poorer glycaemic control (d = 0.40, 95% CI 0.17-0.64). In restricted analyses involving measures adapted for diabetes, associations between eating problems and poorer glycaemic control remained (d = 0.54, 95% CI 0.32-0.76). Disordered eating behaviour (51.8 and 48.1%; d = 0.06, 95% CI -0.05 to 0.21) and eating disorders (6.4 and 3.0%; d = 0.43, 95% CI -0.06 to 0.91) were more common in adolescents with Type 1 diabetes compared with peers, but differences were non-significant. CONCLUSIONS Eating problems are common among this age group. Future work in populations with Type 1 diabetes should develop sensitive measures of eating problems and interventions, and establish predictors of eating problems. Screening in clinics is recommended.
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Affiliation(s)
- V Young
- Department of Psychology, NIHR CLAHRC for South Yorkshire, Medical School, University of Sheffield, Sheffield, UK.
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10
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Gagnon C, Aimé A, Bélanger C, Markowitz JT. Comorbid Diabetes and Eating Disorders in Adult Patients. DIABETES EDUCATOR 2012; 38:537-42. [DOI: 10.1177/0145721712446203] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Purpose The lack of research concerning treatment for individuals with diabetes mellitus (DM) and comorbid eating disorders (ED) contributes to the gulf between the psychosocial needs of individuals with the two conditions and the treatment they receive. Empirical evidence has established that the prognosis of patients with this comorbid diagnosis (ED-DM) is poor in the absence of a specialized DM treatment specifically adapted to ED. In individuals with DM, comorbid ED is associated with numerous complications. Despite these interactions, current knowledge about the comorbid diagnosis is limited, and eating disorders in patients with diabetes often remain undiagnosed. This article presents standard procedures for assessment and optimal therapeutic interventions for patients with ED and DM. Conclusion In patients with diabetes, problematic eating behaviors and symptoms should be assessed routinely. When an eating disorder is detected, diabetes management needs to be adapted, binge eating or medication misuse needs to be addressed, and eating disorder specialists should be included in the multidisciplinary team.
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Affiliation(s)
- Cynthia Gagnon
- University of Quebec in Montreal, Department of Psychology, Montreal, Quebec (Gagnon, doctoral student in psychology)
- University of Quebec in Outaouais, Department of Psychoeducation and Psychology, St-Jerome, Quebec (Dr Aimé)
- University of Quebec in Montreal and Douglas Mental Health Institute and McGill University, Department of Psychology, Montreal, Quebec (Dr Bélanger)
- Joslin Diabetes Center, Section of Genetics and Epidemiology, Boston, Massachusetts (Dr Markowitz)
| | - Annie Aimé
- University of Quebec in Montreal, Department of Psychology, Montreal, Quebec (Gagnon, doctoral student in psychology)
- University of Quebec in Outaouais, Department of Psychoeducation and Psychology, St-Jerome, Quebec (Dr Aimé)
- University of Quebec in Montreal and Douglas Mental Health Institute and McGill University, Department of Psychology, Montreal, Quebec (Dr Bélanger)
- Joslin Diabetes Center, Section of Genetics and Epidemiology, Boston, Massachusetts (Dr Markowitz)
| | - Claude Bélanger
- University of Quebec in Montreal, Department of Psychology, Montreal, Quebec (Gagnon, doctoral student in psychology)
- University of Quebec in Outaouais, Department of Psychoeducation and Psychology, St-Jerome, Quebec (Dr Aimé)
- University of Quebec in Montreal and Douglas Mental Health Institute and McGill University, Department of Psychology, Montreal, Quebec (Dr Bélanger)
- Joslin Diabetes Center, Section of Genetics and Epidemiology, Boston, Massachusetts (Dr Markowitz)
| | - Jessica Tuttman Markowitz
- University of Quebec in Montreal, Department of Psychology, Montreal, Quebec (Gagnon, doctoral student in psychology)
- University of Quebec in Outaouais, Department of Psychoeducation and Psychology, St-Jerome, Quebec (Dr Aimé)
- University of Quebec in Montreal and Douglas Mental Health Institute and McGill University, Department of Psychology, Montreal, Quebec (Dr Bélanger)
- Joslin Diabetes Center, Section of Genetics and Epidemiology, Boston, Massachusetts (Dr Markowitz)
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11
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Takii M, Uchigata Y, Kishimoto J, Morita C, Hata T, Nozaki T, Kawai K, Iwamoto Y, Sudo N, Kubo C. The relationship between the age of onset of type 1 diabetes and the subsequent development of a severe eating disorder by female patients. Pediatr Diabetes 2011; 12:396-401. [PMID: 20723101 DOI: 10.1111/j.1399-5448.2010.00708.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To determine the age of onset of type 1 diabetes that is most closely related to the subsequent development of a severe eating disorder such as anorexia nervosa (AN) or bulimia nervosa (BN). METHODS Participants were 53 female type 1 diabetes patients with AN or BN referred to our outpatient clinic from the Diabetes Center of Tokyo Women's Medical University. Forty-nine female type 1 diabetes patients who regularly visited the Diabetes Center and had no eating disorder-related problems constituted the 'direct control' group, whereas 941 female patients who for the first time visited the Diabetes Center constituted the 'historical control' group. The kernel function method was used to generate a density estimation of the onset age of each group and the chi-square test was used to compare the distribution. RESULTS The control groups had similar density shapes for the onset age of type 1 diabetes, but both differed from the 'eating disorder' group. For onset age 7-18 yr, the density of the 'eating disorder' group was higher than those of the control groups, but for the younger and older onset ages the densities were lower. The 'eating disorder' group developed type 1 diabetes significantly more frequently than the 'historical control' group between 7 and 18 yr of age (χ2 = 9.066, p < 0.011). CONCLUSION The development of type 1 diabetes in preadolescence or adolescence seems to place girls at risk for the subsequent development of AN or BN. Careful attention should be paid to these high-risk patients.
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Affiliation(s)
- Masato Takii
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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12
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Starkey K, Wade T. Disordered eating in girls with Type 1 diabetes: Examining directions for prevention. CLIN PSYCHOL-UK 2010. [DOI: 10.1080/13284201003660101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Karina Starkey
- School of Psychology, Flinders University , Adelaide, South Australia, Australia
| | - Tracey Wade
- School of Psychology, Flinders University , Adelaide, South Australia, Australia
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Marrone S, Plume JW, Kerr P, Pignol A, Vogeltanz-Holm N, Holm J, Larsen MA. The role of free-play physical activity in healthy blood glucose maintenance in children with type 1 diabetes mellitus. PSYCHOL HEALTH MED 2008; 14:48-52. [PMID: 19085311 DOI: 10.1080/13548500801983066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Medical management for children with type 1 diabetes mellitus, including insulin administration to control high blood glucose levels (BGL), is crucial. However, a child-controlled behavioural strategy, like physical activity, to maintain target BGL may be warranted. To demonstrate, pre- and post-activity BGL were collected for 73 children aged 8- to 14-years attending a diabetes camp. Change in BGL across one session of a free-play swimming activity was analysed. Average BGL was significantly reduced from 197.18 mg/dl to 177.78 mg/dl across one 45 min session, and male gender predicted larger reductions. With safety precautions and within the context of appropriate medical management, free-play activity could be used as a strategy for maintaining target BGL.
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Affiliation(s)
- Sonia Marrone
- University of North Dakota School of Medicine and Health Sciences, Center for Health Promotion and Prevention Research, Grand Forks, ND 58202-9037, USA.
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14
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Abstract
Control is a major topic associated with the management of diabetes due to the importance placed on maintaining healthy blood glucose levels in this condition. Such an outcome can be influenced by individuals' sense of mastery over the disease, and more generally over their environment. In response to a diagnosis of diabetes, the self-management requirements accompanying it, and/or difficulties in other areas of life, patients may decide to undertake behaviours that are detrimental to their well-being. For instance, they may adopt fixated attitudes towards their intake and weight. This paper explores the relationship between disordered eating habits, control and diabetes in those who are insulin dependent.
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Affiliation(s)
- S Tierney
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, M13 9PL, UK.
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Vantyghem MC, Press M. Management strategies for brittle diabetes. ANNALES D'ENDOCRINOLOGIE 2007; 67:287-96. [PMID: 17072232 DOI: 10.1016/s0003-4266(06)72600-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Type 1 diabetes is an intrinsically unstable condition. However, the term "brittle diabetes" is reserved for those cases in which the instability, whatever its cause, results in disruption of life and often recurrent and/or prolonged hospitalization. It affects 3/1000 insulin-dependent diabetic patients, mainly young women. Its prognosis is poor with lower quality of life scores, more microvascular and pregnancy complications and shortened life expectancy. Three forms have been described: recurrent diabetic ketoacidosis, predominant hypoglycemic forms and mixed instability. Main causes of brittleness include malabsorption, certain drugs (alcohol, antipsychotics), defective insulin absorption or degradation, defect of hyperglycemic hormones especially glucocorticoid and glucagon, and above all delayed gastric emptying as a result of autonomic neuropathy. Psychosocial factors are very important and factitious brittleness may lead to a self-perpetuating condition. The assessment of brittle diabetes requires quantification of the variability of blood glucose levels. To quantify instability, measures which have been developed, include Mean Amplitude of the largest Glycemic Excursions (MAGE), Mean Of Daily Differences (MODD), Lability Index (LI), Low Blood Glucose Index (LBGI), Clarke's score, Hyposcore, and continuous blood glucose monitoring. Once psychogenic problems have been excluded, therapeutic strategies require firstly, the treatment of underlying organic causes of the brittleness whenever possible and secondly optimising standard insulin therapy using analogues, multiple injections and consideration of Continuous Subcutaneous Insulin Infusion. Alternative approaches may still be needed for the most severely affected patients. Isolated islet transplantation (IIT), which restores glucose sensing, should be considered in cases of hypoglycaemic unawareness and/or lability especially if the body mass index is < 25, but with current immunosuppressive protocols patients must have normal renal function and preferably no plans for pregnancy. Implantable pumps have advantages for patients who either weigh more than 80 kgs or have abnormalities of kidney or liver function or are highly sensitised.
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Affiliation(s)
- M-C Vantyghem
- Endocrinology and Metabolism Department/ERIT-M0106, Lille University Hospital, 6 Rue du Pr Laguesse, 59037 Lille Cedex, France.
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Doherty Y, Dovey-Pearce G. Understanding the developmental and psychological needs of young people with diabetes. ACTA ACUST UNITED AC 2005. [DOI: 10.1002/pdi.751] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Iafusco D, Vanelli M, Gugliotta M, Iovane B, Chiari G, Prisco F. Prevalence of eating disorders in young patients with type 1 diabetes from two different Italian cities. Diabetes Care 2004; 27:2278. [PMID: 15333502 DOI: 10.2337/diacare.27.9.2278] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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