NEW YORK (Reuters Health) – Disturbed eating behaviors (DEB) in adolescents and emerging adults with type 1 diabetes transitioning to adult care are associated with worse diabetes self-management, according to a longitudinal study.
Previous studies have reported DEB in as many as 30% of adolescent girls and 10% of adolescent boys with type 1 diabetes, and an estimated 20% to 40% of youth with type 1 diabetes turn to insulin restriction or omission for manipulating their body weight.
Dr. Koen Luyckx of the University of Leuven, in Belgium, and the University of the Free States, in Bloemfontein, South Africa, and colleagues surveyed 300 youth (age 16-28 years) with type 1 diabetes at one-year intervals to evaluate DEB and its association with self-management, glycemic control, diabetes distress and depressive symptoms.
They separated these individuals into four groups based on their Diabetes Eating Problem Survey-Revised scores: 65.7% were in the low DEB group; 8% were in the increasing DEB group; 7.3% were in the decreasing DEB group; and 19% were in the persistent DEB group.
DEB was unrelated to age and illness duration, but individuals with a higher body mass index (BMI) were at increased risk for DEB, the researchers report in Diabetes Care, online June 19.
Males were relatively overrepresented in the low-DEB group, whereas females were overrepresented in the persistent and increasing DEB groups.
The low-DEB group scored lowest on diabetes distress, depressive symptoms, and hemoglobin A1c and highest on self-management. The persistent-DEB group had the least adaptive scores on these variables. The increasing-DEB and decreasing-DEB groups showed intermediate outcomes.
The increasing-DEB group experienced decreases in self-management over time, and the decreasing-DEB group experienced improvements in self-management over time, while the low-DEB and persistent-DEB groups remained fairly stable.
“Without any intervention, DEB and insulin manipulation may worsen and feed into substantial complications over time, given their prospective link with higher HbA1c values,” the researchers conclude. “Diabetes management of youth with DEB can only improve (after) appropriate treatment begins for DEB.”
Dr. Luyckx did not respond to a request for comments.
Diabetes Care 2019.