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Embaye J, Hennekes M, Snoek F, de Wit M. Psychometric properties of the Diabetes Eating Problem Survey-Revised among Dutch adults with type 1 diabetes and implications for clinical use. Diabet Med 2024; 41:e15313. [PMID: 38439144 DOI: 10.1111/dme.15313] [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: 11/10/2023] [Revised: 02/02/2024] [Accepted: 02/21/2024] [Indexed: 03/06/2024]
Abstract
AIMS Disordered eating behaviour (DEB) in people with type 1 diabetes (T1D) can be screened with the Diabetes Eating Problem Survey-Revised (DEPS-R). This study aimed to investigate the psychometric properties of the DEPS-R among Dutch adults with T1D and to explore the individual items alongside the standard cut-off score of ≥20 for clinical use. METHODS The construct validity of the DEPS-R was assessed with an exploratory factor analysis, through principal axis factoring and with Spearman correlations between clinical variables and the DEPS-R. Backward logistic regression identified clinical predictors for DEPS-R scores above the cut-off. DEPS-R item responses were summarized with frequencies, means and standard deviations. RESULTS Participants were 145 adults with T1D, of whom 79.3% were women and 35.9% presented with DEB based on the cut-off. A single-factor solution of the DEPS-R showed good internal consistency, while a three-factor solution showed acceptable to good internal consistency within the factors. A younger age, a higher BMI and more diabetes distress were predictors for a DEPS-R cut-off score of ≥20. Clinically relevant items were identified that contributed minimally to the DEPS-R score. CONCLUSIONS This study supports a single-factor and a three-factor structure of the DEPS-R while also suggesting an item-specific or factor-specific approach in clinical practice.
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Affiliation(s)
- Jiska Embaye
- Departmant of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Mareille Hennekes
- Departmant of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Frank Snoek
- Departmant of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Maartje de Wit
- Departmant of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands
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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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Goldshmid AE, Balakshina NA, Amosova MV, Poluboyarinova IV, Fadeev VV. The combination of type 1 diabetes and eating disorder during pregnancy. DIABETES MELLITUS 2022. [DOI: 10.14341/dm12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The problem of eating disorders currently holds a special place in clinical practice. Bulimia nervosa is one of the main forms of eating disorders, characterized by the difficulty in its treatment and a long, recurrent course. Eating disorders are common in patients with type 1 diabetes mellitus (T1D), especially in adolescent girls.In this article, we present a clinical case of a patient with T1D and bulimia nervosa, which developed before the manifestation of T1D and progressed against its background. The patient is overly concerned with controlling body weight, specifically restricted the intake of carbohydrates, forcibly caused vomiting. During pregnancy fasting ketonuria («low-carb ketone») was repeatedly detected. The minimum weight was 37 kg (BMI 15.2 kg/m2). Particular interest of this case is the course of pregnancy, which ended in the antenatal death. The possible cause could be the restriction on carbohydrate food and prolonged stay in ketosis, that might lead to the development of pregnancy pathology. Additional examination also revealed multiple complications of diabetes and recurrent depressive disorder, which requires conjoint monitoring by an endocrinologist and a psychiatrist.Combination of T1D and eating disorder in a pregnant patient should be considered as an atypical course of the disease.
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Affiliation(s)
- A. E. Goldshmid
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - N. A. Balakshina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - M. V. Amosova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | - V. V. Fadeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Salvia MG, Ritholz MD, Craigen KLE, Quatromoni PA. Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients' perceptions and lived experiences. J Eat Disord 2022; 10:148. [PMID: 36221145 PMCID: PMC9554983 DOI: 10.1186/s40337-022-00666-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The overlap in prevalence between type 2 diabetes and binge eating disorder is substantial, with adverse physical and mental health consequences. Little is known about patients' efforts at managing these two conditions simultaneously. The research objective was to explore patients' experiences managing co-existing type 2 diabetes or prediabetes and binge eating disorder. METHODS This is a qualitative descriptive study using semi-structured interviews. Participants included 21 women with type 2 diabetes or prediabetes (90% non-Hispanic White; mean age 49 ± 14.8 years, mean BMI 43.8 ± 8.4; 48% with type 2 diabetes and mean HbA1c was 8.4%). Interviews were analyzed using thematic analysis and NVivo software. RESULTS Qualitative analysis revealed that participants reported binge episodes frequently started in childhood or adolescence and went undiagnosed for decades; notably, they recalled that diabetes diagnosis preceded the binge eating disorder diagnosis. They also described trying to lose weight throughout their lives and how feelings of deprivation, shame, and failure exacerbated binge eating. Participants further reported how binge eating made diabetes self-care and outcomes worse. Finally, participants observed that when binge eating disorder treatment and diabetes management were synergistically integrated, they experienced improvements in both binge eating and glycemic outcomes. This integration included reframing negative thoughts surrounding binge eating disorder and diabetes self-management and increasing their understanding of how the two disorders were inter-related. CONCLUSION Findings highlight the importance of increasing healthcare providers' awareness of and screening for binge eating disorder in the treatment of diabetes and inform specific integrated interventions that address both diagnoses. From this study where we interviewed 21 women with binge eating disorder (BED) and type 2 diabetes/prediabetes, we learned how binge eating impacted diabetes management and how diabetes impacted BED. Most participants reported receiving the diabetes diagnosis before being diagnosed with BED despite the earlier onset of binge eating, pointing to the need for BED screening. Participants described trying to lose weight throughout their lives and reported feelings of failure and shame, which made binge eating worse. Binge eating made diabetes management harder, but when diabetes and BED treatment were aligned, participants experienced improvements in binge symptoms and diabetes outcomes.
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Affiliation(s)
- Meg G Salvia
- Department of Health Sciences, Boston University, 635 Commonwealth Avenue, 02215, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA
| | - Marilyn D Ritholz
- Joslin Diabetes Center, 1 Joslin Place, 02215, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, 401 Park Drive, 02215, Boston, MA, USA
| | | | - Paula A Quatromoni
- Department of Health Sciences, Boston University, 635 Commonwealth Avenue, 02215, Boston, MA, USA. .,Walden Behavioral Care, 51 Sawyer Road, 02453, Waltham, MA, USA.
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Priesterroth L, Grammes J, Strohm EA, Kubiak T. Disordered eating behaviours and eating disorders in adults with type 1 diabetes (DEBBI): rational and design of an observational longitudinal online study. BMJ Open 2022; 12:e064863. [PMID: 36113939 PMCID: PMC9486289 DOI: 10.1136/bmjopen-2022-064863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Disordered eating behaviours (DEB) and eating disorders (ED) are among the most common mental health comorbidities of type 1 diabetes. However, research on diabetes-specific risk and protective factors is limited. To this end, comprehensive characterisations of DEB and ED in type 1 diabetes, as well as longitudinal research on the course of DEB and ED, are needed to gain more insight. The 'Disordered eating behaviours and eating disorders in diabetes type I' (DEBBI) study aims to describe DEB/ED and their correlates in people with type 1 diabetes, to identify key diabetes-specific, psychosocial risk and protective factors, and to describe the course of DEB over time. METHODS AND ANALYSIS The DEBBI study is a longitudinal online survey with follow-up assessments after 6, 12 and 18 months, targeted at adults who have been diagnosed with type 1 diabetes for at least 12 months. The survey covers data on diabetes diagnosis and self-management (eg, diabetes treatment and complications), lifestyle (eg, eating habits, physical activity), psychosocial well-being (eg, anxiety, depressive symptoms) and demographic and medical information. It includes validated instruments and self-generated items. One key aspect of the data analysis will be latent profile analyses to determine latent subtypes of DEB manifestation in people with type 1 diabetes and their courses over time, including data on the clinical picture and symptoms, behaviours and diabetes-specific complications. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the State Medical Chamber of Rhineland-Palatine, Germany (ID 2021-16040). Participants give informed written consent before starting the survey. The DEBBI study will provide more clarity in the so far inconsistent empirical evidence base and will help to inform research on prevention and intervention strategies that are tailored to diabetes-specific needs. TRIAL REGISTRATION NUMBER The study is registered with DRKS German Clinical Trials Register (DRKS00028833).
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Affiliation(s)
| | - Jennifer Grammes
- Health Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Edda Anna Strohm
- Health Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Thomas Kubiak
- Health Psychology, Johannes Gutenberg University, Mainz, Germany
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Ritholz M, Salvia M, Craigen KLE, Quatromoni P. What helps and what hinders primary care treatment for women with type 2 diabetes and binge eating disorder? A qualitative study. Diabet Med 2022; 39:e14887. [PMID: 35593036 DOI: 10.1111/dme.14887] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/17/2022] [Indexed: 12/01/2022]
Abstract
AIM Although binge-eating disorder (BED) is a common comorbidity of type 2 diabetes, little is known about the treatment experiences for persons with both conditions. Our aim was to explore perceptions of Primary Care Providers' (PCPs') treatment among adult women with both diagnoses. METHODS In this qualitative descriptive study, we conducted semi-structured interviews with a sample of 21 women (90% non-Hispanic white; mean age 49 ± 14.8 years, mean body mass index [BMI] 43.8 ± 8.4; 48% had type 2 diabetes, mean HbA1c 68 mmol/mol, 8.4%) who had previously participated in a secondary care specialized eating disorder treatment programme. Interviews were audio-recorded, transcribed and analysed using thematic analysis and NVivo 12. RESULTS Participants described PCPs' helpful and unhelpful attitudes and behaviours during type 2 diabetes and BED treatment experiences. Helpful treatment was experienced when PCPs demonstrated a person-centred approach by providing adequate diabetes education, individualized care and non-judgmental attitudes from which participants reported increased understanding of diabetes and BED, improved diabetes self-care and fewer negative self-perceptions. Unhelpful treatment occurred when PCPs did not provide sufficient diabetes education and manifested deficient understanding of BED characterized by simplistic advice or judgmental attitudes, from which participants reported having limited knowledge and understanding of diabetes and BED, low self-efficacy, diminished trust and feelings of guilt, shame and failure. CONCLUSIONS We propose a preliminary pathways treatment model derived from our findings, which utilizes integrated type 2 diabetes and BED education and person-centred collaboration. This preliminary model needs to be tested in quantitative research with a larger sample.
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Affiliation(s)
- Marilyn Ritholz
- Joslin Diabetes Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret Salvia
- Boston University, Boston, Massachusetts, USA
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Paula Quatromoni
- Boston University, Boston, Massachusetts, USA
- Walden Behavioral Care, Waltham, Massachusetts, USA
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7
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Shakeri Z, Mardali F, Azizabadi Farahani M, Alemrajabi M, Mottaghi A. Comparison of eating disorders and eating behaviors in adults with and without type 2 diabetes prior to bariatric surgery. J Eat Disord 2022; 10:107. [PMID: 35854337 PMCID: PMC9295507 DOI: 10.1186/s40337-022-00623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. ED consists wide range of morbidity such as loss of eating control, binge eating disorder (BED), night eating syndrome, and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, we compared eating disorders and eating behaviors in adults with and without type 2 diabetes prior to bariatric surgery. METHODS 284 participants with class III obesity were included in the single center study. Each case (patients with type 2 diabetes) and control (patients without type 2 diabetes) groups consists 142 patients. Loss of eating control, BED and Bulimia nervosa, Night eating syndrome and eating behaviors and psychosocial factors were screened with standard questionnaires. SPSS version 20 was used for statistical analysis. A P-value of < 0.05 was considered significant. RESULTS There was a significant difference between participants with and without type 2 diabetes in case of BED (76.3% vs. 47.3%, P = 0.001). The logistic regression model has shown that participants without type 2 diabetes had lower odds of exhibiting BED (OR = 0.28, 95% CI 0.142-0.552). Among participants without type 2 diabetes, men had 65% high odds of BED (OR = 1.65, 95% CI 1.13-2.53) in compare with women. Participants with and without type 2 diabetes with high school degree (OR = 5.54, 95% CI 2.46-9.45, P = 0.0001 and OR = 6.52, 95% CI 3.15-10.56, respectively) and moderate depression level (OR = 2.03, 95% CI 0.98-3.95 and OR = 3.12, 95% CI 2.12-4.56, P = 0.0001) had higher odds of BED. CONCLUSION These results probably indicate that people with Class III obesity are more cautious about their diet for blood glucose control if they have type 2 diabetes. Future studies are recommended to follow up these patients after surgery to compare weight loss and blood sugar control in patients with and without type 2 diabetes.
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Affiliation(s)
- Zeinab Shakeri
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Farzaneh Mardali
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Azadeh Mottaghi
- Research Center for Prevention of Cardiovascular Diseases, Institute of Endocrinology and Metabolism, University of Medical Sciences, Tehran, Iran.
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Watt A, Ng AH, Sandison A, Fourlanos S, Bramley A. Prevalence of disordered eating in adults with type 1 diabetes in an Australian metropolitan hospital. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e974-e980. [PMID: 34250682 DOI: 10.1111/hsc.13500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 04/06/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study is to establish the prevalence of disordered eating behaviours and establish its identifiable factors in adults with T1D attending a large tertiary hospital service. In this cross-sectional study, 199 participants with TID, aged 18-65 years, completed the revised Diabetes Eating Problem Survey-Revised (DEPS-R). Additional demographic and medical data obtained included age, sex, BMI, HbA1C, duration of diabetes and number of hospital admissions within 12 months (including diabetic ketoacidosis). A DEPS-R score of ≥20, indicative of disordered eating behaviour, was evident in 31% of participants. A DEPS-R score of ≥20 was associated with being female (39% females vs. 23.3% males; p = .016) and a high HbA1c (8.9% [7.8-10.2] vs. 8.0% [7.3-8.7], median [IQR], p < .001). The prevalence of disordered eating behaviours increased significantly with BMI, from 21.3% in the healthy BMI group (18.5-24.9 kg/m2 ) to 37.1% in the group with BMI > 25 kg/m2 (p = .02). A DEPS-R score of ≥20 was often driven by questions related to a desire to lose weight, meal patterns and glycaemic control. While these behaviours may be attributed to desirable self-management behaviours for adults with T1D, the DEPS-R is still a useful tool to identify patients with potential disordered eating behaviours and the need for dietetic intervention.
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Affiliation(s)
- Arleen Watt
- Clinical Nutrition Department, Royal Melbourne Hospital, Melbourne, Australia
| | - Ashley H Ng
- Discipline of Dietetics and Human Nutrition, La Trobe University, Bundoora, Vic., Australia
| | - Ashley Sandison
- Diabetes and Endocrinology Department, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Spiros Fourlanos
- Diabetes and Endocrinology Department, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - Andrea Bramley
- Discipline of Dietetics and Human Nutrition, La Trobe University, Bundoora, Vic., Australia
- Workforce Innovation, Strategy, Education & Research (WISER) Unit, Monash Health, Clayton, Vic., Australia
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Goddard MG, Oxlad M. Insulin Restriction or Omission in Type 1 Diabetes Mellitus: A Meta-synthesis of Individuals' Experiences of Diabulimia. Health Psychol Rev 2022; 17:227-246. [PMID: 34979879 DOI: 10.1080/17437199.2021.2025133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Unique to individuals with insulin-dependent diabetes mellitus (IDDM) is a disordered eating behaviour whereby insulin is deliberately restricted or omitted. Despite growing research in this area, experiential perspectives of individuals remain understudied. Therefore, the purpose of this meta-synthesis was to explore the experiences of individuals with Type 1 Diabetes Mellitus (T1DM) by identifying, analysing and synthesising existing knowledge concerning their misuse of insulin for weight control. DESIGN Meta-aggregative techniques were employed to generate synthesised findings related to individuals' understanding and experience, physical and psychological impacts, support and treatment-related needs and experiences, noted in twelve studies. RESULTS A multifaceted relationship with the unique disordered eating behaviour, beyond weight control was identified. Many individuals experienced a wide range of diabetes-related complications from insulin restriction and omission alongside increased distress, loss of control and feelings of regret, guilt, and shame later in life. Almost all individuals valued peer support from those who shared a 'diabulimic' identity; peer support appeared more conducive to recovery than support from friends, family and formal support services, which were not uniformly supportive. CONCLUSIONS This meta-synthesis revealed valuable information from individuals with diabulimia which has widespread interdisciplinary implications and may provide useful guidance concerning the prevention and treatment of this unique behaviour. The results highlight the need for empathic, collaborative care, and proactive prevention and early intervention. Furthermore, the findings highlight the value of peer support in recovery, the need for increased knowledge among family and friends, training among multidisciplinary teams and support services, and crucially the development of evidence-based treatments informed by the behaviour as a unique distinct construct.
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Affiliation(s)
| | - Melissa Oxlad
- School of Psychology, The University of Adelaide, Australia
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10
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Prevention of eating disorders in specialty care. NUTR HOSP 2022; 39:129-137. [DOI: 10.20960/nh.04188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Sanchez C, Grzenda A, Varias A, Widge AS, Carpenter LL, McDonald WM, Nemeroff CB, Kalin NH, Martin G, Tohen M, Filippou-Frye M, Ramsey D, Linos E, Mangurian C, Rodriguez CI. Social media recruitment for mental health research: A systematic review. Compr Psychiatry 2020; 103:152197. [PMID: 32992073 PMCID: PMC7704547 DOI: 10.1016/j.comppsych.2020.152197] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/14/2020] [Accepted: 08/06/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Social media holds exciting promise for advancing mental health research recruitment, however, the extent and efficacy to which these platforms are currently in use are underexplored. OBJECTIVE A systematic review was conducted to characterize the current use and efficacy of social media in recruiting participants for mental health research. METHOD A literature review was performed using MEDLINE, EMBASE, and PsychINFO. Only non-duplicative manuscripts written in the English language and published between 1/1/2004-3/31/2019 were selected for further screening. Data extracted included study type and design, participant inclusion criteria, social media platform, advertising strategy, final recruited sample size, recruitment location, year, monetary incentives, comparison to other recruitment methods if performed, and final cost per participant. RESULTS A total of 176 unique studies that used social media for mental health research recruitment were reviewed. The majority of studies were cross-sectional (62.5%) in design and recruited adults. Facebook was overwhelmingly the recruitment platform of choice (92.6%), with the use of paid advertisements being the predominant strategy (60.8%). Of the reviewed studies, substance abuse (43.8%) and mood disorders (15.3%) were the primary subjects of investigation. In 68.3% of studies, social media recruitment performed as well as or better than traditional recruitment methods in the number and cost of final enrolled participants. The majority of studies used Facebook for recruitment at a median cost per final recruited study participant of $19.47. In 55.6% of the studies, social media recruitment was the more cost-effective recruitment method when compared to traditional methods (e.g., referrals, mailing). CONCLUSION Social media appears to be an effective and economical recruitment tool for mental health research. The platform raises methodological and privacy concerns not covered in current research regulations that warrant additional consideration.
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Affiliation(s)
- Catherine Sanchez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Adrienne Grzenda
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Andrea Varias
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Alik S Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Linda L Carpenter
- Department of Psychiatry and Human Behavior, Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - William M McDonald
- Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta, GA, USA
| | - Charles B Nemeroff
- Department of Psychiatry, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Glenn Martin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Maria Filippou-Frye
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Drew Ramsey
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Eleni Linos
- Department of Dermatology, Stanford University, Stanford, CA, USA
| | - Christina Mangurian
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; UCSF Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA; UCSF Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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12
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Coleman SE, Caswell N. Diabetes and eating disorders: an exploration of 'Diabulimia'. BMC Psychol 2020; 8:101. [PMID: 32967730 PMCID: PMC7513317 DOI: 10.1186/s40359-020-00468-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/17/2020] [Indexed: 11/22/2022] Open
Abstract
Background ‘Diabulimia’ is the term given to the deliberate administration of insufficient insulin for the purpose of weight loss. Although Diabulimia can be life-threatening and prevalence rates in diabetes are high, there is a lack of research for how to effectively support people with the condition. This exploratory study aimed to provide much-needed information to healthcare professionals and guide the focus for future research. Methods Forty-five individuals with Type 1 diabetes mellitus (T1DM) and a history of insulin misuse completed an online questionnaire. This included an assessment of their eating disorder psychopathology with the Eating Disorder Examination Questionnaire (EDE-Q) and 16 open-ended questions exploring their experience of Diabulimia. The responses to the open-ended questions were analysed using thematic analysis. Results The average global EDE-Q score was 3.96 (1.21), which is consistent with eating disorder populations. Common themes identified were concerns about weight, difficulty coping with diabetes, past trauma, and the importance of relationships. Experiences with health professionals were overwhelmingly negative. Most participants had experienced serious medical intervention due to Diabulimia and were fully aware of the consequences of insulin restriction. Conclusions Overall, individuals believed that a greater awareness of Diabulimia and more training for healthcare professionals is needed. While education on insulin misuse may be a necessary first step in treatment, psychological support is crucial. To deliver effective treatment, clinicians should be aware of the specific issues facing those with Diabulimia. The current study identified themes that clinicians may find useful to consider.
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Affiliation(s)
| | - Noreen Caswell
- Senior Lecturer, School of Psychology, University of Central Lancashire, Preston, UK
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13
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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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14
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Broadley MM, Zaremba N, Andrew B, Ismail K, Treasure J, White MJ, Stadler M. 25 Years of psychological research investigating disordered eating in people with diabetes: what have we learnt? Diabet Med 2020; 37:401-408. [PMID: 31797439 DOI: 10.1111/dme.14197] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 12/29/2022]
Abstract
Disordered eating is a serious and under-recognized problem in people with diabetes. This narrative review summarizes the research contributions made by psychological science over the past 25 years to the study of disordered eating in people with type 1 or type 2 diabetes, and identifies gaps and future directions relevant to both healthcare professionals and researchers. Key focus areas of psychological research investigating disordered eating in people with diabetes have been: (1) defining and classifying types of disordered eating; (2) identifying demographic, diabetes-specific and psychosocial correlates of disordered eating, and developing theoretical models of disordered eating in people with type 1 diabetes; (3) identifying the physical and psychosocial consequences of disordered eating; and (4) developing screening measures to identify disordered eating in people with type 1 diabetes. Psychological science has made significant contributions over the past 25 years to our understanding of the nature of this problem and the multiple factors which may interrelate with disordered eating in people with diabetes. Key areas for further attention include: (1) a better definition of disordered eating subtypes in people with type 1 diabetes; (2) characterizing disordered eating in people with type 2 diabetes; and (3) developing multidisciplinary, evidence-based prevention and treatment interventions for comorbid disordered eating and diabetes.
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MESH Headings
- Behavioral Research/history
- Behavioral Research/methods
- Behavioral Research/trends
- Biomedical Research/history
- Biomedical Research/methods
- Biomedical Research/trends
- Diabetes Complications/epidemiology
- Diabetes Complications/etiology
- Diabetes Complications/psychology
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/psychology
- Feeding and Eating Disorders/complications
- Feeding and Eating Disorders/epidemiology
- Feeding and Eating Disorders/psychology
- History, 20th Century
- History, 21st Century
- Humans
- Psychology/history
- Psychology/methods
- Psychology/trends
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Affiliation(s)
- M M Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - N Zaremba
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
| | - B Andrew
- Queensland University of Technology School of Psychology and Counselling, Kelvin Grove, QLD, Australia
- Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - K Ismail
- Department of Psychological Medicine, Diabetes Psychology and Psychiatry Research Group, Weston Education Centre, London, UK
| | - J Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M J White
- Queensland University of Technology School of Psychology and Counselling, Kelvin Grove, QLD, Australia
- Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - M Stadler
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
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15
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Eating behaviours associated with glycaemic variability and fear of hypoglycaemia in adults with type 1 diabetes. DIABETES & METABOLISM 2019; 47:101136. [PMID: 31838059 DOI: 10.1016/j.diabet.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/01/2019] [Indexed: 11/23/2022]
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Luyckx K, Verschueren M, Palmeroni N, Goethals ER, Weets I, Claes L. Disturbed Eating Behaviors in Adolescents and Emerging Adults With Type 1 Diabetes: A One-Year Prospective Study. Diabetes Care 2019; 42:1637-1644. [PMID: 31217162 DOI: 10.2337/dc19-0445] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/31/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Disturbed eating behavior (DEB) is prevalent in youth with type 1 diabetes and is accompanied by an increased risk for complications, morbidity, and mortality. Prospective studies on DEB in the challenging transition to adulthood are scarce. This longitudinal study examined DEB over a 1-year period and investigated the directionality of effects linking DEB to diabetes-specific functioning and depressive symptoms in adolescents and emerging adults. RESEARCH DESIGN AND METHODS Three hundred youth (16-28 years old) with type 1 diabetes participated in a two-wave longitudinal study. Questionnaires measured DEB (Diabetes Eating Problem Survey-Revised [DEPS-R]), self-management, diabetes distress, and depressive symptoms. HbA1c values were obtained from physicians. Mixed ANOVA and cross-lagged analysis were used to examine prospective changes and directionality of effects, respectively. RESULTS Mean DEB remained stable in the total sample, but significant individual differences were observed based on the cutoff score of the DEPS-R: 19% displayed persistent DEB and 8% increased and 7.3% decreased in DEB over time. The remaining individuals scored low on DEB over time. These four groups were differentiated based on insulin restriction, omission, diabetes-specific functioning, and depressive symptoms. Cross-lagged analyses indicated that DEB predicted relative increases in depressive symptoms over time, whereas reciprocal associations with glycemic control were found. CONCLUSIONS This longitudinal study highlights the substantial impact DEB may have in the transition to adulthood, with a substantial portion of youth with type 1 diabetes being at risk for clinical DEB. Prospective pathways linking DEB to functioning were found, emphasizing the clinical relevance of assessing DEB over time.
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Affiliation(s)
- Koen Luyckx
- University of Leuven, Leuven, Belgium .,Unit for Professional Training and Service in the Behavioral Sciences, University of the Free State, Bloemfontein, South Africa
| | - Margaux Verschueren
- University of Leuven, Leuven, Belgium.,FWO Research Foundation Flanders, Brussels, Belgium
| | | | - Eveline R Goethals
- University of Leuven, Leuven, Belgium.,Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Ilse Weets
- Free University Brussels, Brussels, Belgium
| | - Laurence Claes
- University of Leuven, Leuven, Belgium.,University of Antwerp, Antwerp, Belgium
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Ryman B, MacIsaac J, Robinson T, Miller MR, Herold Gallego P. Assessing the clinical utility of the diabetes eating problem survey-revised (DEPS-R) in adolescents with type 1 diabetes. Endocrinol Diabetes Metab 2019; 2:e00067. [PMID: 31294083 PMCID: PMC6613221 DOI: 10.1002/edm2.67] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/28/2019] [Accepted: 03/02/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Eating disorders are prevalent among adolescents with type 1 diabetes (T1D). We examined the clinical utility of the Diabetes Eating Problem Survey-Revised (DEPS-R), a brief self-report questionnaire developed for patients with T1D, to identify at-risk adolescents. We aimed to determine whether a positive DEPS-R screen was predictive of a formal diagnosis of an eating disorder as per the DSM-V. In addition, we assessed whether other variables including psychosocial characteristics and diabetes conflict were associated with an abnormal DEPS-R screen. METHODS Cross-sectional study of 116 T1D adolescents aged 12-17 years. All participants completed the DEPS-R screening; both participants and parents completed a questionnaire addressing psychosocial characteristics/conflict around diabetes management. Clinical variables were obtained from participant charts. Differences were examined between positive and negative DEPS-R groups. Adolescents who screened positive were offered a referral to a specialized eating disorder team for further assessment. RESULTS From 116 participants (mean age ± SD = 14.6 years ± 1.56), 21% (24/116) scored positive for DEPS-R More females than males had abnormal DEPS-R (75% vs 25%, P = 0.001). Those with positive DEPS-R score had higher HbA1c% (mean = 9.3 ± 1.3 vs 8.3 ± 1.2, P = 0.001). Positive DEPS-R group had higher conflict score for diabetes management in both parents' and children's assessments (both ps < 0.001). In regression analysis, being female (OR males = 0.07, 95%CI: 0.010-0.46, P = 0.006), older (OR = 2.01, 95%CI: 1.16-3.48, P = 0.040) and > child-reported conflict (OR = 1.78, 95%CI: 1.02-3.11, P = 0.044) were predictors of an abnormal DEPS-R score. CONCLUSION The DEPS-R score is a useful clinical tool for identifying T1D adolescents at risk for disordered eating behaviour, but has a low positive predictive value (PPV) for identifying adolescents who meet diagnostic criteria for an eating disorder. Female gender, suboptimal diabetes control and increased conflict in diabetes management are associated with an abnormal DEPS-R score.
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Affiliation(s)
- Brianna Ryman
- Department of PaediatricsWestern UniversityLondonOntarioCanada
| | - Jenna MacIsaac
- Department of PaediatricsWestern UniversityLondonOntarioCanada
| | - Tracy Robinson
- Department of PaediatricsWestern UniversityLondonOntarioCanada
| | - Michael R. Miller
- Department of PaediatricsWestern UniversityLondonOntarioCanada
- Children’s Health Research Institute, Children’s Hospital, London Health Sciences CentreLondonOntarioCanada
| | - Patricia Herold Gallego
- Department of PaediatricsWestern UniversityLondonOntarioCanada
- Pediatric Endocrinology SectionChildren’s Hospital, London Health Sciences Centre (LHSC)LondonOntarioCanada
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18
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Dietary patterns as a red flag for higher risk of eating disorders among female teenagers with and without type I diabetes mellitus : Adolescents with type I diabetes mellitus are a risk factor for eating disorders: a case-control study. Eat Weight Disord 2019; 24:151-161. [PMID: 28913823 DOI: 10.1007/s40519-017-0442-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Female adolescents with type I diabetes mellitus (TIDM) have an increased risk of developing eating disorders (ED) due to the dietary recommendations. OBJECTIVE Investigate the association between dietary intake and increased risk of ED. METHODS Case-control study with 50 T1DM female adolescents (11-16 years) and 100 healthy peers (CG). Measures included food frequency questionnaire (FFQ-PP), Child-EDE.12, economic and anthropometric data. RESULTS Comparing female adolescents with T1DM vs CG, the first had higher intake of: bread, cereal, rice, and pasta (29.7 vs 23.8%, p = 0.001), vegetables (6.5 vs 2.8%, p < 0.001), milk yogurt and cheese (9.9 vs 7.6%, p = 0.032), fat, and oils (8.2 vs 5.9%, p = 0.003), besides higher fiber intake (19.2 vs 14.7%, p = 0.006) and lower consumption of sweets (13.6 vs 30.7%, p < 0.001). No differences on ED psychopathology (Child-EDE subscales and global score) were found between groups. In unadjusted association between the ED psychopathology and dietary intake, a diet rich in fiber was significantly associated with both the global and eating concern scores. Among CG, increased intake of meat, poultry, fish, and eggs and decreased bread, cereal, rice, and pasta consumption were significantly associated with higher ED psychopathology. When BMI and age are adjusted, the association between fiber intake and ED psychopathology is no longer significant among diabetic participants; however, in the CG, this association remains. CONCLUSIONS The study suggests that an association between dietary intake and ED psychopathology might exist in female adolescents with and without TIDM and that careful evaluation of the dietary profile and risk of developing an ED should be considered in clinical practice. LEVEL OF EVIDENCE Level III, case-control study.
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Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018; 19 Suppl 27:136-154. [PMID: 30062718 DOI: 10.1111/pedi.12738] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 07/16/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Carmel E Smart
- Department of Paediatric Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia.,School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
| | | | | | | | | | - Carlo L Acerini
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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20
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De Paoli T, Rogers PJ. Disordered eating and insulin restriction in type 1 diabetes: A systematic review and testable model. Eat Disord 2018; 26:343-360. [PMID: 29182474 DOI: 10.1080/10640266.2017.1405651] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM To provide an overview of the existing literature pertaining to insulin restriction as a disordered eating behaviour in individuals with type 1 diabetes and present a novel maintenance model: The Transdiagnostic Model of Disordered Eating in Type 1 Diabetes. METHOD A systematic review was conducted of the current literature relevant to insulin restriction and/or omission in the context of disordered eating in type 1 diabetes. A new maintenance model was then developed by incorporating diabetes-specific factors into existing eating disorder models. RESULTS Type 1 diabetes may complicate the development and maintenance of disordered eating behaviour. Diabetes-specific circumstances, including disease diagnosis, insulin management, insulin restriction, and diabetes-related complications, contribute to the maintenance of disordered eating cognitions and behaviours. DISCUSSION The proposed model offers a comprehensive representation of insulin restriction as a disordered eating behaviour in type 1 diabetes. Future research should test the model to further understand the mechanisms underlying disordered eating in type 1 diabetes and inform treatments for this at-risk population.
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Affiliation(s)
- Tara De Paoli
- a Melbourne School of Psychological Sciences , The University of Melbourne , Melbourne , VIC , Australia
| | - Peter J Rogers
- b Nutrition and Behaviour Unit, School of Experimental Psychology , University of Bristol , Bristol , United Kingdom
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21
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Keane S, Clarke M, Murphy M, McGrath D, Smith D, Farrelly N, MacHale S. Disordered eating behaviour in young adults with type 1 diabetes mellitus. J Eat Disord 2018; 6:9. [PMID: 29744106 PMCID: PMC5930421 DOI: 10.1186/s40337-018-0194-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/05/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The combination of eating disorders and diabetes is associated with increased risk of morbidity and mortality. The aim of this study is to compare the prevalence of disordered eating behaviour (DEB) in young adults with type 1 diabetes mellitus to a sample of non-diabetic controls, and to examine the relationship of DEB to glycaemic control. METHODS The Eating Disorder Examination Questionnaire (EDE-Q) was administered to 51 individuals aged 18-30 years attending an outpatient diabetic clinic in a large university teaching hospital. Glycaemic control was assessed by the glycosylated haemoglobin (HbA1c). The control group comprised a consecutive sample of 236 male and female students aged 18-30 years attending a university primary health care service. RESULTS The mean global EDE-Q score for the diabetes group was 0.82 ± 1.1 (mean ± SD) and the mean for the control group was 1.4 ± 1.3 (mean ± SD). The diabetes group was significantly more likely to have a lower global EDE-Q score compared to the control group. There was no association between the global EDE-Q score of the diabetes group and HbA1c level. CONCLUSIONS We did not find increased levels of disordered eating behavior (DEB) in young adults with type 1 diabetes mellitus compared to a non-diabetic control sample.
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Affiliation(s)
- S Keane
- 1Department of Psychiatry, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
| | - M Clarke
- 1Department of Psychiatry, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
| | - M Murphy
- 1Department of Psychiatry, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
| | - D McGrath
- 2Trinity College Health Service, Dublin, Ireland
| | - D Smith
- 3Department of Endocrinology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
| | - N Farrelly
- 2Trinity College Health Service, Dublin, Ireland
| | - S MacHale
- 1Department of Psychiatry, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
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