Abstract
BackgroundPeople with diabetes have been shown to be at risk for disordered eating compared to their non-diabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction.MethodsSecondary school students (n = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cut-offs for disordered eating behaviours were generated for analysis.ResultsDisordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; p < 0.001), laxative use (diabetes 15.4%, no diabetes 2.1%; p < 0.001), use of cigarettes (diabetes 26.9%, no diabetes 4.3%; p < 0.001) and other drugs (diabetes 28.9%, no diabetes 4.0%; p < 0.001), cleanse/detox (diabetes 30.8%, no diabetes 10.5%; p < 0.001) and extreme weight loss diets (diabetes 13.5%, no diabetes 4.7%; p < 0.003) were higher in those reporting a diagnosis of diabetes. In addition, 17% of those with diabetes reported frequent insulin restriction (≥ once per week), and insulin restriction was associated with more frequent disordered eating behaviours.ConclusionThere was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples.
Highlights
Eating disorders are complex mental health disorders and have one of the highest mortality and suicide rates of any mental illness [1, 2]
This study found that several disordered eating behaviours were more common in adolescents with diabetes, including self-induced vomiting, laxative use, use of cigarettes and other illicit drugs, detox and extreme weight loss diets
The aim of this study was to evaluate a range of disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers in a large community-based population sample of Australian adolescents, as well as to evaluate disordered eating behaviours according to insulin restriction in adolescents reporting diabetes
Summary
Eating disorders are complex mental health disorders and have one of the highest mortality and suicide rates of any mental illness [1, 2]. Meta-analytical data has shown that the prevalence of disordered eating behaviours are increasing in the general population [3,4,5] and a recent study found the point prevalence of any clinical or subclinical eating disorder to be 22% in Australian adolescents [6]. Another common health problem in adolescence is diabetes, predominantly Type 1 Diabetes (T1D) [7]. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction
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