1135-P: Screening for Disordered Eating Behaviors in Youth with Type 1 Diabetes—Feasible and Necessary

Abstract

The American Diabetes Association (ADA) recommends screening adolescents with type 1 diabetes (T1D) for disordered eating behaviors (DEB) using the Diabetes Eating Problem Survey-Revised (DEPS-R) tool, however this is not routinely done in clinical practice. We implemented screening for DEB in a large academic pediatric diabetes center as part of clinical care as well as to evaluate the prevalence of DEB and identify clinical factors (in particular, use of pumps and continuous glucose monitors (CGM)) associated with a positive screen. Youth with T1D between 13-19 years, seen in our pediatric diabetes clinic from 02/09/2022 - 06/07/2022, were given the survey. A total of 580 subjects were eligible for the screening, 368 (64%) completed it and 282 (~50%) had analyzable data (49% female, 83% white, 11% black, 3% reporting food insecurity (FI), mean (SD) age 16.4±1.9 years, HbA1c 8.2±1.9%, BMI percentile 71.2±26.9). The majority were on CGM (77%) and 45% on pump therapy (including 5% on hybrid close loop systems). A total of 43 (15%) had a positive screen (score≥ 20) for DEB. There was a higher proportion of females, (67 vs 45%, p=0.007) lower proportion of white (70 vs 85%) and higher proportion of black youth (20 vs 8%) (p=0.02) in those that screened positive vs negative. Those with a positive screen also had a higher HbA1c (9.9±2.1 vs 8±1.7, p<0.001) and BMI percentile (83.1±21.1 vs 68.9±27.3, p<0.001). There was no difference in age (16.5±1.9 vs 16.4±1.9 years, p=0.82), report of FI (4.6 vs 2.1%, p=0.76), use of CGM (72 vs 78%, p=0.35), or pump therapy (35 vs 44%, p-0.26) between the two groups. None of those on hybrid close loop had a positive screen, however the numbers were small (n=7). Almost 1 in 5 adolescents with T1D had a positive screen for DEB. There was no difference in the use of diabetes technology. Our findings stress the importance of screening for DEB in youth with T1D and implementation of strategies to improve response rate in order to make timely referrals to reduce associated morbidity. Disclosure S.Sastry: None. M.Coren: None. J.Schreiber: None. I.Libman: Advisory Panel; Novo Nordisk.