Search Results (8)

Adolescents with Type 1 Diabetes Mellitus (T1DM) face a significantly increased risk of developing disordered eating behaviors (DEBs), a phenomenon that includes the deliberate omission of insulin, commonly referred to as diabulimia. The aim of this systematic review and meta-analysis was to determine the prevalence of diabulimia in adolescents with T1DM and consolidate the scientific evidence on this issue. Following PRISMA guidelines, observational studies published in English and Spanish involving adolescents aged 10 to 19 were identified through comprehensive searches in SCOPUS, LILACS, PubMed, Web of Science, and PsycINFO. After rigorous screening and eligibility assessment, 13 studies were included. Data were extracted independently, and meta-analyses were performed using random-effects models. Reported prevalence rates of DEB in T1DM varied widely among studies, ranging from 20.8% to 48%. The pooled prevalence in the final meta-analytic model was 11% (95% CI: 9–13%), with prevalence substantially higher in females (45%) than males (26%). These findings highlight not only the elevated risk of DEB and diabulimia among adolescents with T1DM but also considerable gender differences likely shaped by psychological, sociocultural, and biological factors. The lack of standardized diagnostic criteria for diabulimia remains a barrier to clinical management. Early detection and gender-sensitive preventive strategies are crucial for reducing complications and improving the quality of life in this vulnerable population. Full article

Background/Objectives: This study assesses the prevalence of diabulimia in Greek children and adolescents with Type 1 Diabetes Mellitus (T1DM) by using the Diabetes Eating Problem Survey—Revised (DEPS-R) questionnaire and addresses a gap in the literature on eating disorders (EDs) and disordered eating behaviors (DEBs) in this population. The DEPS-R threshold score of ≥20, although originally established in international studies, has also been applied in Greek adult validation studies. However, it has not yet been formally validated in Greek youth. Methods: Participants aged 9–18 years, diagnosed with T1DM a minimum of one year before the start of the study, were recruited from three pediatric departments in Thessaloniki and were asked to complete the Greek version of the DEPS-R questionnaire. Appropriate statistical analysis was employed to investigate the association of the DEPS-R score with anthropometric, demographic, and glycemic variables derived from the clinical assessment and the patient’s medical records. Results: Girls had significantly higher DEPS-R scores compared with boys. Significant positive associations were observed between the DEPS-R score and both age (r = 0.212, p = 0.020) and Body Mass Index (BMI) (r = 0.419, p < 0.001). A significant association with Glycated Hemoglobin (HbA1c) (r = 0.182, p = 0.047) suggested that poorer glycemic control may be linked to disordered eating, although no significant associations were identified with physical activity or type of insulin therapy. Conclusions: Older age, higher Body Mass Index (BMI) and elevated Glycated Hemoglobin (HbA1c) levels are associated with increased risk of disordered eating in youth with T1DM, especially in girls. Therefore, the implementation of early screening and targeted interventions is imperative. Full article

The literature describes an increased risk of eating disorders (EDs) in patients with Type 1 diabetes mellitus (T1DM) compared to the general population. This risk is mainly related to physical and psychosocial problems related to diabetes. EDs should be carefully assessed and treated in these patients since they are associated with poor glycemic control and significant repercussions of pathology. Background/Objectives: To study the presence of EDs in young Portuguese adults and adults with T1DM, and how gender; age group; method of insulin administration; carbohydrate counting; and body mass index [BMI] variables influence the risk of developing an ED. Methods: Data collection was carried out using an online questionnaire, which was disseminated through the media of several Portuguese diabetes associations. Results: The sample consisted of 47 participants, mostly female, with the age group between 26 and 35 years being most representative. A statistically significant association was found between the Eating Attitudes Test [EAT-26] scores and the BMI of the participants [p = 0.003]; other variables did not show statistically significant differences. Conclusions: To better understand the relationship between these two pathologies, further studies are needed, as well as the development of more screening instruments to assess the risk of EDs specific to T1DM, and preventive interventions and guidelines that can assist the various areas of health that support the population with T1DM. Full article

Adolescence, a critical period of physical and psychological development, presents unique challenges in type 1 diabetes (T1D) management due to endocrinological changes, reduced therapeutic adherence, and elevated susceptibility to psychological issues such as depression, anxiety, and eating disorders. This narrative review explores the impact of psychological and behavioral factors on glycemic control in adolescents with T1D. We examine the prevalence and influence of mental health disorders, lifestyle factors, harmful behaviors, and social dynamics on diabetes management and glycemic outcomes. Strategies for improving metabolic control are also reviewed, including cognitive behavioral therapy, technological devices, and educational interventions. The importance of tailored psychological support, family involvement, and targeted interventions to improve adherence to treatment and glycemic control in adolescents with T1D should be emphasized. Full article

Eating disorders (ED) represent complex conditions with multifactorial etiopathogenesis. Recent scientific findings suggest that diabetes, a chronic disease profoundly influencing eating habits, could significantly contribute to the risk of developing ED. Both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) patients are identified as susceptible to developing binge eating disorder (BED) and other dysfunctional eating behaviors, such as diabulimia, a condition not yet officially recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Diabulimia is characterized by a deliberate choice to omit or limit necessary insulin doses, with the aim of losing weight or limiting weight gain. This scoping review aims to consolidate the latest evidence on the bidirectional relationship between ED and diabetes, as well as their impact on patients’ quality of life. The findings from various studies reveal varied prevalence estimates, as diabetic patients often do not meet the formal diagnostic criteria for ED. Nonetheless, having diabetes appears to increase the risk of developing dysfunctional eating patterns. Simultaneously, the presence of an ED may heighten the risk of developing T2DM. Given this bidirectional relationship between ED and diabetes, this evidence underscores the importance for healthcare professionals, particularly those in diabetes care, to implement screening programs aimed at preventing and/or treating ED. Such initiatives could significantly improve patient outcome and quality of life. Full article

Background: Diabulimia is associated with “resistance to treatment”, impaired glycemic control, and increased risk of diabetic complications. The aim of this study was to explore the possible lifestyle and diet factors associated with diabulimia using the “Diabetes Eating Problem Survey-Revised” (DEPS-R), a questionnaire assessing the risk of diabulimia in patients with T1DM. Methods: 100 outpatients with a diagnosis of T1DM for over a year, from two hospitals in Athens, Greece were asked to complete a questionnaire about their medical history and lifestyle behaviors along with the Eating Attitudes Test (EAT-26), the Beck Depression Scale (BDI-II) and the DEPS-R. Results: Multivariate linear regression analysis showed statistically significant associations between DEPS-R score and HbA1c% levels (b = 4.447, 95% CI 3.220–5.675), sex (male) (b = −4.413, 95% CI −8.778–−0.047, weight perception higher than normal (b = 9.896, 95% CI 5.266–14.526), time spent walking minutes per week (b= −0.019, 95% CI −0.031–−0.006), having received diabetes nutritional education (b = −5.128, 95%CI −10.141–−0.115), eating breakfast (b = −6.441, 95% CI −11.047–−1.835) and having a first relative diagnosed with an eating disorder (b = 6.164, 95%CI 0.030–12.298). The presence of these factors could help highlight the profile of potential individuals at risk of diabulimia and enhance preventive interventions. Full article

Chronic diseases have a negative impact on quality of life and perceived well-being. Depression tends to be more frequent in people with chronic diseases than the general population, and, for example, in diabetes, it has an incidence of two to three times higher and often remains under-diagnosed. The inability to control and predict the course of the disease exposes chronic patients to mood fluctuations which are often difficult to manage, also in virtue of the fact that in any chronic pathology a stabilization aimed at attenuating the symptoms or slowing the course is pursued, but it cannot tend to achieve complete healing. This fact of incurability for many subjects means the loss of control over their own body, in which the social and family role is also perceived as compromised and the experienced distress can result in the appearance of underlying disorders, both psychological or psychiatric. In this area, there is currently a great deal of focus on sex/gender differences. The aim of this article is to highlight these differences with regard to the emotional aspects that most affect the management of diabetic pathology. In this paper, we will underline a particularly underestimated eating disorder: diabulimia, then that the perception of itself is not only related to the sex assigned at birth, but also to the gender that is acquired during life, and we will also analyze the three phases related to the acquisition of gender identity during the evolutionary period. Finally, we will talk about the use of technology in diabetic patients (insulin pumps, continuous glucose monitoring variably integrated into each other) that might generate a series of psychological–behavioral reactions related to the integration between technology and body image and the experience of social acceptance of the individual, particularly in the evolution age. Full article

Type 1 diabetes mellitus (T1DM) patients occasionally develop disordered eating behaviors, leading to insulin manipulation without medical consultation, targeting to achieve weight control. In clinical practice, the Diabetes Eating Problem Survey-Revised Version (DEPS-R) questionnaire has been used to evaluate eating disorders in T1DM patients. This study was conducted to validate the factor structure of the Greek version of DEPS-R using Confirmatory Factor Analysis (CFA), to investigate its reliability and convergent validity in Greek T1DM adults and to compare a single factor DEPS-R model with multiple factor models. Participants were 103 T1DM adults receiving insulin, who responded to DEPS-R. Their anthropometric, biochemical and clinical history data were evaluated. The sample presented good glycemic control and 30.1% scored above the established DEPS-R cut-off score for disturbed eating behavior. CFA results revealed that the data fit well to the factor models. The DEPS-R scale had good reliability and was positively linked to BMI, HbA1c, total daily dose and time in range. Model comparison supported the superiority of the 1-factor model, implying that Greek clinicians and practitioners might not have to consider individualized treatment based on various scores across different subscales but they can adopt a single DEPS-R score for an easy and efficient screening for disordered eating. Full article