Eating Disorders and Type 1 Diabetes: a perspective

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

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

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

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

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

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

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

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

Disordered Eating Behaviors in Youth With Type 1 Diabetes

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

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

Diabetes and Eating Disorders

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

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

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

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

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

scholarly journals Disordered Eating Behaviors Are Not Increased by an Intervention to Improve Diet Quality but Are Associated With Poorer Glycemic Control Among Youth With Type 1 Diabetes

Diabetes Care ◽  
2018 ◽  
Vol 41 (4) ◽  
pp. 869-875 ◽  
Author(s):  
Miriam H. Eisenberg Colman ◽  
Virginia M. Quick ◽  
Leah M. Lipsky ◽  
Katherine W. Dempster ◽  
Aiyi Liu ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Disordered Eating ◽  
Diet Quality ◽  
Eating Behaviors ◽  
Disordered Eating Behaviors

scholarly journals An Examination of Sex Differences in a Disease-Specific Model of Disordered Eating Behaviors in Type 1 Diabetes

2019 ◽  
Vol 45 (1) ◽  
pp. 91-100 ◽  
Author(s):  
Laura B Smith ◽  
Nicole Foster ◽  
Sureka Bollepalli ◽  
Hannah F Fitterman-Harris ◽  
Diana Rancourt
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Eating Disorder ◽  
Disordered Eating ◽  
Eating Behaviors ◽  
Eating Disorder Risk ◽  
Disordered Eating Behaviors ◽  
Disease Specific ◽  
Disorder Risk

Abstract Objective Preliminary evidence supports the integration of type 1 diabetes (T1D) disease-specific factors into eating disorder risk models. The current study explored whether cross-sectional associations among constructs included in the modified dual pathway model of eating disorder risk for individuals with T1D are similar across sex among adolescents and young adults with T1D. Methods Original study participants were recruited from the T1D Exchange Clinic Network, a U.S. registry of individuals with T1D. Online surveys included measures of general eating disorder risk factors, hypothesized T1D-specific risk factors, and a T1D-specific eating disorder questionnaire. The current study is a secondary analysis with the adolescents (13–17 years; n = 307; 46.9% female) and young adults (18–25 years; n = 313; 62.6% female) from the original sample. In the absence of strong measurement invariance for all measures of interest, sex-specific path models were estimated among the adolescent and young adult cohorts. Results Only two paths emerged as significant in the female, but not male, adolescent model. In the young adult cohort, all significant paths were the same across sex. Conclusions Both general and T1D-specific risk factors are associated with disordered eating behaviors in the T1D population. Patterns of associations were similar across male and female youth with T1D, suggesting that sex-specific prevention approaches to disordered eating behaviors among T1D youth may not be warranted.

scholarly journals Risky Business

2011 ◽  
Vol 37 (6) ◽  
pp. 756-764 ◽  
Author(s):  
Sarah S. Jaser ◽  
Heather Yates ◽  
Susan Dumser ◽  
Robin Whittemore
Keyword(s):  
Type 1 Diabetes ◽  
Risk Behaviors ◽  
Health Care Providers ◽  
Eating Behaviors ◽  
Future Research ◽  
Care Providers ◽  
Disordered Eating Behaviors ◽  
Unprotected Sexual Activity ◽  
Diabetes Educators

Purpose The purpose of this article is to review risk behaviors and their health consequences in adolescents with type 1 diabetes. The existing literature on common risk behaviors in adolescents is examined, with a focus on illicit drug use, alcohol use, smoking, unprotected sexual activity, and disordered eating behaviors. Conclusions A review of the literature highlights the lack of studies of risk behaviors in this population. Much of what is known comes from studies with adolescents in the general population or from studies of adults with type 1 diabetes. Known risk and protective factors for risk behaviors and health outcomes are noted. Based on these findings, suggestions are provided for diabetes educators and health care providers to assess for and prevent risk behaviors in adolescents with type 1 diabetes. Directions for future research in this population are indicated, including the need to develop and test standardized prevention programs.

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