Abstract
BackgroundThis study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control.MethodsIn a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c.ResultsA total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006).ConclusionsBecause of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.
Highlights
Everyday challenges for patients with childhood-onset type 1 diabetes mellitus (T1D) include the regular monitoring of blood glucose; the balancing of insulin administration, food intake and physical activity; and the fear of acute and late diabetes-related complications
Neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men
Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, among men, regular mental health screening is recommended for young adults with type 1 diabetes
Summary
Everyday challenges for patients with childhood-onset type 1 diabetes mellitus (T1D) include the regular monitoring of blood glucose; the balancing of insulin administration, food intake and physical activity; and the fear of acute and late diabetes-related complications. These patients are at a higher risk of depression and eating disorders than their peers without diabetes [1]. One study was a meta-analysis estimating the prevalence of clinical depression among adults with T1D between 2000 and 2004. People with T1D were four times more likely to have clinical depression than people without T1D (pooled prevalence 12.0% vs 3.2%) [4]. In another study using the same screening tool, the prevalence of adolescents and young adults (age 11–25 years) with T1D screening positive for depression was analyzed. This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control
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