Prevalence and Multidimensional Model of Disordered Eating in Youths With Type 1 Diabetes: Results From a Nationwide Population-Based Study
Authors: Troncone Alda , Affuso Gaetana , Cascella Crescenzo , Chianese Antonietta , Zanfardino Angela , Iafusco Dario ,   Diabetes Study Group of Italian Society of Paediatric Endocrinology and Diabetology, Lera Riccardo , Bracciolini Giulia Patrizia , Grosso Caterina , Bertelli Enrica , Cherubini Valentino , Piccinno Elvira , Delvecchio Maurizio , Ortolani Federica , Vendemiale Marcella , Rutigliano Alessandra , Zecchino Clara , Zucchini Stefano , Maltoni Giulio , Scarponi Dorella , Fraternale Lucia , Gallo Francesco , Coccioli Maria Susanna , Brugnola Vito , Ripoli Carlo , Ricciardi Maria Rossella , Galassi Sabrina Maria , Pascarella Filomena , Perrotta Angelo , Golino Anna , Stamati Filomena Andreina , Presti Donatella Lo , Nicoletti Manuela Caruso , Saggio Annalisa , Citriniti Felice , Sperlì Domenico , De Marco Rosaria , Borselli Maria Daniela , Lazzaro Nicola , De Donno Valeria , Giordana Cristina , Toni Sonia , Balbo Verena , d'Annunzio Giuseppe , Minuto Nicola , Bassi Marta , Parodi Alice , Caloiero Mimma , Aloe Monica , Corsini Maria , Lia Rosanna , Lombardo Fortunato , Salzano Giuseppina , Passanisi Stefano , Pecoraro Maria , Bonfanti Riccardo , Pozzi Clara , Curto Stefano , Piscopo Alessia , del Giudice Emanuele Miraglia , Testa Veronica , Rollato Assunta Serena , Pennarella Alessandro , Rabbone Ivana , Pignatiello Ciro , Savastio Silvia , Antoniotti Valentina , De Berardinis Fiorella , Santoro Giacomo , Iovane Brunella , Dioni Silvia , Lia Maria Carmela , Tutino Rita , Cianfarani Stefano , Schiaffini Riccardo , Patera Ippolita Patrizia , Matteoli Maria Cristina , Carducci Chiara , Rutigliano Irene , D'Onofrio Grazia , de Santis Luisa , Trada Michela , Tinti Davide , Montarulo Cinzia , Cardinale Giuliana , De Leo Sofia , Arnaldi Claudia , Longo Barbara 
Published: March 2023

Objective

The aim of this study was to report nationwide data of the prevalence of disordered eating behaviors (DEBs) in adolescents with type 1 diabetes (T1D) and to evaluate a multidimensional model of eating problems, analyzing how psychopathological problems are associated with DEBs and with metabolic control.

Methods

This study was carried out using a cross-sectional design with a sample of 1,562 patients with T1D (812 male), aged 11–19 years. Participants were recruited from multiple pediatric diabetes centers (N = 30) located in northern, central, and southern Italy, and they individually completed the Diabetes Eating Problem Survey–Revised (DEPS-r) and the Youth Self-Report (YSR). Sociodemographic and clinical data were also gathered. Multiple-group structural equation modeling was used to investigate the relationships between internalizing/externalizing symptoms, DEBs, and glycosylated hemoglobin (HbA1c) values.

Results

A total of 29.7% of the participants reported DEBs (DEPS-r scores ≥20), 42.4% reported insulin manipulation (IM). The prevalence of DEBs was higher for female participants (p ≤ .001). The model explains 37% of the variance in disordered eating, 12% in IM, and 21% in HbA1c values. Body mass index, externalizing symptoms, and internalizing symptoms were significantly and positively associated with DEBs, which in turn were significantly and positively associated with HbA1c values (all p ≤ .001). Externalizing (p ≤ .001) and internalizing (p ≤ .01) symptoms were also directly associated with HbA1c values.

Conclusion

Given the relevant prevalence of DEBs, their significant positive association with psychopathological symptoms, and their relationship with worse diabetes outcomes, regular psychological screening and support is needed to ensure the best care of adolescents with T1D.