Associations between Executive Dysfunction and Disordered Eating Behavior (DEB) Risk in Teens with Type 1 Diabetes (T1D)

Abstract

Background: The adolescent brain remains immature with ongoing development in areas such as executive function (EF). DEBs also commonly emerge during adolescence. We explored associations between EF and risk of DEBs in teens, ages 13-17, with T1D. Methods: EF was assessed by the Behavior Rating Inventory of Executive Function (BRIEF), both teen self-report and parent proxy-report versions. Scores ≥60, as total (Global Executive Composite [GEC]) score or on 2 indices (Behavioral Regulation [BRI] and Metacognition [MI]) or 8 subscales, indicate EF problems. DEB risk was assessed by the Diabetes Eating Problem Survey Revised (DEPS-R). DEB risk was categorized by DEPS-R scores: low risk <10; moderate risk 10-19; high risk ≥20. Results: Teens (N=169, 46% female) were aged 15.9±1.3 (M±SD) years and had T1D for 8.4±3.7 years; A1c was 8.5±1.2% and 44% were overweight/obese. Based on teen self-reported DEPS-R score, 59% had low DEB risk, 29% moderate risk, and 12% high risk. Higher DEB risk was significantly associated with EF problems by teen self-report on GEC, BRI, and MI and by parent report on BRI (Figure). EF subscales associated with DEB risk included emotional control, organization, task completion, goal setting, and problem-solving. Conclusion: In teens with T1D, executive dysfunction was associated with DEB risk, suggesting need for future study of the relationship between EF and DEBs. Disclosure R. Cecilia-Costa: None. M. Hansmann: None. K.R. Harrington: None. L. Volkening: None. L.M. Laffel: Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US, MannKind Corporation, Roche Diagnostics Corporation, Dexcom, Inc., Insulet Corporation, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Johnson & Johnson Diabetes Institute, LLC..