Longitudinal Assessment of Disordered Eating Behavior (DEB) Risk in Teens with Type 1 Diabetes (T1D)

Abstract

DEBs in T1D are associated with poor glycemic control and development of diabetes complications. We assessed progression of risk for DEBs over 18 months in 169 teens, ages 13-17, with T1D. Teens completed the Diabetes Eating Problem Survey-Revised (DEPS) every 6 months. Teens were categorized by DEB risk: low, DEPS<10; moderate, DEPS 10-19; high, DEPS≥20. At baseline, teens (54% male) were 14.9±1.3 (M±SD) years old and had T1D for 7.4±3.7 years; 37% were overweight/obese. A1c was 8.5±1.0%; 68% were pump treated. Baseline DEB risk assessment included 60% at low risk, 27% at moderate risk, and 12% at high risk. Initial DEB risk was highly predictive of DEB risk after 18 months (Figure). Most teens (66%) stayed at their same risk level, 14% improved, and 20% progressed. In a multivariate mixed model predicting DEPS scores over 18 months, female sex (p=.0002), overweight/obesity (p=.0004), less frequent BG monitoring (p=.0008), and higher A1c (p=.003) significantly and independently predicted higher DEPS scores. Without intervention, DEB risk appears to remain relatively stable in teens with T1D. Therefore, it is important to prevent onset of DEBs, potentially by targeting teens who are female and overweight/obese as well as teens who are less adherent (e.g., few BG checks/day) and have rising A1c levels. Identifying DEB risk may permit early intervention and prevention of progression to clinical eating disorders. Disclosure R. Cecilia-Costa: None. Z. Guo: 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..