Bidirectional Relationships between Eating Disorders and Type 1 and 2 Diabetes: A Scoping Review

Round 1

Reviewer 1 Report

A well designed study, many publication sites besides Pubmed. I am not acquainted with some of those. Would Google Scholar, Embase and other contributed with DOI/ISSN-registered studies (relevant but not meeting Pubmed standard?) - Please comment!

Abstract, introduction and methods ok, Results presentation clear.  Discussion ok, but could be expanded.

Socio-cultural differences can affect the results and the authors reflect on this under Limitations. What about education level and socio-economics? Please comment!

My personal experience (being an academic) of my academic friends with both types of diabetes, is that they have full control of their diet and insulin and other anti-diabetic drug treatments - Please comment!

I have not many detailed comments, but I think that the discussion could be improved with better discussion of their results contra references/previous studies.

Could you believe queries on eating habits?

What type of insulin is involved? Insulin pen or semi- and long-duration insulins?

Insulin dose - with low doses - omitting a dose is probably not dangerous

Author Response

Dear Reviewer,

We would like to express our sincere gratitude for taking the time to review our manuscript and for your valuable suggestions. We have carefully considered each of the points raised and are pleased to provide the following responses and clarifications. The suggested changes have been incorporated into the manuscript, thereby strengthening the scientific soundness and relevance of our study. Below, you will find our detailed responses to each of your comments:

1. As specified in our methodology, we used the Discovery database of the University of Catania for our research. This tool was chosen because of its inclusive nature, as it includes access to multiple authoritative databases such as PubMed, Health & Medical Collection, PubMed Central, Springer Online Journals Complete, ScienceDirect Journals, ScienceDirect Freedom Collection 2021, and Wiley Online Library. In response to your comment, we performed additional checks on Google Scholar and Embase for additional studies. However, we found that the studies in these databases were already included in our dataset obtained through Discovery, confirming the completeness of our initial search. This approach allowed us to conduct a comprehensive, high-quality systematic review, ensuring the inclusion of a wide range of relevant studies from a variety of recognized academic sources, including those with registered DOIs/ISSNs that may not meet the standard PubMed criteria but are nonetheless significant to our search.
2. We have revised and expanded the discussion section, providing a more in-depth analysis of our findings in relation to previous studies and existing literature.
3. We agree on the importance of these factors and thank you for pointing out this gap. We have added a reflection on the possible impact of educational level and socioeconomic status on the study results. These items have been included in the limitations and considerations section for future research.
4. We appreciate the sharing of your personal experience. It is true that individuals with high levels of education and access to resources may demonstrate better control over their condition. However, it is important to note that our results reflect a broader range of experiences, including individuals with different socioeconomic and educational backgrounds. We added a note in the discussion to highlight how factors such as access to information and resources may influence disease management.
5. Our study considered several types of insulin, including insulin pens and medium- and long-acting insulins. We clarified this point in the methods section.
6. We appreciate this observation. We added a discussion of the relationship between insulin dose and the potential risk associated with omitting a dose. We pointed out that although omission of low doses may seem less risky, it is still important to maintain a consistent treatment regimen for optimal diabetes management.

Reviewer 2 Report

My comments concern the laconic presentation of the topic. The article is valuable, but needs to expand the sessions to meet the criteria of high substantive and pragmatic. The authors should search more databases for literature to confirm and solidify the state of affairs.

Specific comments are not warranted here, as they are concerned with expanding the text to a higher level of scientific generality. 

Author Response

Dear reviewer,

Thank you for your valuable feedback on our manuscript. We have made the necessary changes to expand the sections and enhance the substantive and pragmatic value of the article. Additionally, we conducted further searches across multiple databases to strengthen and solidify the current understanding of the topic. Your comments regarding achieving a higher level of scientific generality have been carefully considered, and we have revised the manuscript accordingly. We believe these updates have significantly improved the comprehensiveness and depth of analysis in our study. We are confident that these revisions have strengthened the manuscript and look forward to your further feedback.

The authors

Round 2

Reviewer 2 Report

Dear Authors,

thank you for your response to the review.

The corrections made are satisfactory.

Now the article fully meets the journal's criteria and I recommend it for publication.

Dear Authors,

thank you for your response to the review.

The corrections made are satisfactory.

Now the article fully meets the journal's criteria and I recommend it for publication.