Disordered eating behavior in youths with diabetes diminishes quality of life
SAN DIEGO — Disordered eating behavior in youth and young adults with type 1 or type 2 diabetes results in poorer blood glucose control, higher BMI, lower quality of life and higher depressive symptoms compared with those without the behaviors, according to a speaker here.
“Disordered eating behavior as a broader term generally refers to the presence of inappropriate behaviors with eating in order to lose weight,” Angel Siu-Ying Nip, MD, a fellow in endocrinology and diabetes division at the University of Washington, said during a press conference. “It is relatively common in female adults who have type 1 diabetes, and approximately 30% have reported to have some disordered eating behaviors. We think that children with diabetes are also vulnerable with having an intense focus on food and weight control as part of their diabetes management.”
Nip and colleagues evaluated data from the SEARCH for Diabetes in Youth Study on 2,156 youth and young adults (mean age, 17.7 years; mean diabetes duration, 8.1 years) with type 1 diabetes and 161 with type 2 diabetes (mean age, 21.8 years; mean diabetes duration, 8 years) to describe the prevalence, characteristics and outcomes associated with disordered eating behaviors.
All participants completed the Diabetes Eating Problem Survey-Revised (DEPS-R) questionnaire.
“The survey contains 16 diabetes-related specific questions, which have been validated in children with type 1 diabetes,” Nip said. “A cutoff score of 20 or above reflected disordered eating behaviors. Though it has not been validated in children with type 2 diabetes, we think some of the questions are also relevant in assessing the problem in that population.”
Overall, 21.2% of participants with type 1 diabetes and 52.2% with type 2 diabetes had disordered eating defined as a DEPS-R score of at least 20.
Higher BMI, lower insulin sensitivity, poorer quality of life and more depressive symptoms were all associated with higher DEPS-R scores in all participants. More participants with type 2 diabetes reported challenges maintaining a healthy weight while controlling diabetes (60.3% for type 2 diabetes vs. 31.5% for type 1 diabetes), a concern that eating is out of control (34.8% vs. 19.1%), a desire to be thin even at the expense of good diabetes control (34.2% vs. 12.4%) and binge eating (50.3% vs. 27.5%). Nearly 20% of all participants endorsed insulin omission to lose weight.
“This is a common problem, yet it is underrecognized and underdetermined,” Nip said. “We recommend screening for disorder eating behaviors starting in early adolescence in the clinic setting. There is a need to develop collaboration and effective interventions for youth and young adults with disordered eating behaviors.” – by Amber Cox
Nip AS, et al. 802-P. Presented at: American Diabetes Association 77th Scientific Sessions; June 9-13, 2017; San Diego.
Disclosures: The researchers report no relevant financial disclosures.