Disordered Eating, Body Mass, and Glycemic Control in Adolescents With Type 1 Diabetes

• Published in: Diabetes care Vol. 24; no. 4; pp. 678 - 682
• Main Authors: MELTZER, Lisa J, JOHNSON, Suzanne Bennett, PRINE, Jason M, BANKS, Richard A, DESROSIERS, Paul M, SILVERSTEIN, Janet H
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.04.2001
• Subjects: Adolescent; Adult and adolescent clinical studies; Age Factors; Anorexia nervosa; Associated diseases and complications; Attitudes; Biological and medical sciences; Blood Glucose - metabolism; Body Image; Body Mass Index; Body Weight; Bulimia; Bulimia - complications; Bulimia - epidemiology; Bulimia - psychology; Child; Child development; Clinics; Complications and side effects; Continental Population Groups; Cross-Sectional Studies; Demographic aspects; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Eating behavior; Eating behavior disorders; Eating disorders; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Feeding and Eating Disorders - complications; Feeding and Eating Disorders - epidemiology; Feeding and Eating Disorders - psychology; Feeding Behavior; Female; Females; Florida; Health aspects; Hemoglobin; Humans; Insulin; Male; Medical sciences; Miscellaneous; Patients; Personality Inventory; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Research design; Risk factors; Self image; Sex Factors; Teenagers; Thinness - psychology; Type 1 diabetes; Youth; Florida; United States; Endocrinopathy; Human; Immunopathology; Body mass index; Hemoglobin A1c; Body image; Adolescent; Insulin dependent diabetes; Autoimmune disease; Predictive factor; Eating disorder; Blood plasma
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.24.4.678

Disordered Eating, Body Mass, and Glycemic Control in Adolescents With Type 1 Diabetes Lisa J. Meltzer , MS 1 , Suzanne Bennett Johnson , PHD 4 , Jason M. Prine , BS 2 , Richard A. Banks , MD 5 , Paul M. Desrosiers , MD 5 and Janet H. Silverstein , MD 3 1 Clinical and Health Psychology 2 Psychology 3 Pediatrics, and the 4 Center for Pediatric Psychology and Family Studies, University of Florida, Gainesville, Florida 5 Nemours Children’s Clinic, Orlando, Florida Abstract OBJECTIVE —To examine the relationship between disordered eating attitudes and behaviors, BMI, and glycemic control in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS —In a cross-sectional design, 152 adolescents (ages 11–19 years) completed three scales from the Eating Disorders Inventory (EDI): Body Dissatisfaction, Drive for Thinness, and Bulimia. All subjects had diabetes for >1 year. Glycemic control was assessed by glycosylated hemoglobin (HbA 1c ). Height and weight were measured to assess BMI. RESULTS —Adolescents with type 1 diabetes did not report more disordered eating attitudes and behaviors than the normative comparison sample. Male subjects with type 1 diabetes reported fewer symptoms of bulimia and female subjects with type 1 diabetes reported greater body satisfaction than the normative group. A higher BMI was a significant predictor of greater body dissatisfaction, more so for female than male subjects. Symptoms of bulimia were associated with older adolescence and female sex. Those with more symptoms of bulimia were also more likely to have a higher BMI. Sex (female) and body dissatisfaction (more dissatisfied) predicted a stronger desire to be thin. Longer duration of disease, more symptoms of bulimia, and obesity all predicted poorer glycemic control. CONCLUSIONS —Female patients aged 13–14 years seem to be at greatest risk for developing disordered eating patterns. Using the clinical cutoff score (≥5) of the EDI Bulimia subscale as a screener in diabetes clinics may help identify adolescents whose disordered eating patterns are likely to compromise their glycemic control. DCCT, Diabetes Control and Complications Trial EDI, Eating Disorders Inventory Footnotes Address correspondence and reprint requests to Suzanne Bennett Johnson, PhD, Center for Pediatric Psychology and Family Studies, University of Florida Health Science Center, P.O. Box 100165, Gainesville, FL 32610-0165. E-mail: sjohnson{at}hp.ufl.edu . Received for publication 23 May 2000 and accepted in revised form 20 October 2000. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.