Young people with type 1 diabetes (T1D) and type 2 diabetes (T2D) are at increased risk for developing disordered eating primarily because of the intense focus on diet and weight control that accompanies the management of diabetes. This study, “Disordered Eating Behaviors in Youth and Young Adults with Type 1 and Type 2 Diabetes: The SEARCH for Diabetes in Youth Study” (802–P), investigated the occurrence of disordered eating behaviors in youth and young adults with diabetes, and was focused on defining the characteristics associated with disordered eating, including age, body mass index (BMI) and health outcomes.

Using data obtained from SEARCH for Diabetes in Youth, a population–based observational study conducted at five sites in the United States, data on 2,156 youth with T1D (average age of 17.7 years) and T2D (average age of 21.8 years) was analyzed. The participants included in the analysis were diagnosed with diabetes between 2002 and 2008, and had two or more study visits, including a “Cohort” visit between 2011 and 2015. During the Cohort visit, the participants had a brief exam, blood and urine samples were collected, and questionnaires completed, including the Diabetes Eating Problem Survey – Revised (DEPS–R).

Results indicated that disordered eating behaviors (DEPS–R score >= 20) were observed in 21.2 percent of the study participants with T1D and 52.2 percent of the participants with T2D. Disordered eating behaviors were more common in females with T1D and in those who were overweight. Higher DEPS–R scores (DEPS–R score >= 20) were associated with higher BMI, in both the participants with T1D (p<0.01) and the participants with T2D (p<0.01). Approximately 20 percent of the T1D participants reported skipping insulin for weight control, and more than 20 percent of all of the participants indicated they faced challenges in maintaining a healthy weight while managing diabetes. Some of the participants with T1D (12.4 percent) and some with T2D (34.2 percent) indicated they had a desire to be “thin at the expense of good diabetes control.” Overall, the participants with disordered eating had poorer health outcomes, including higher A1C levels, more depressive symptoms and poorer quality of life.

“Disordered eating behaviors are often under–recognized among patients with diabetes, and this may complicate their diabetes management, glucose control and overall general health,” said lead study author Angel Siu Ying Nip, MD, fellow in pediatric endocrinology at the University of Washington. “It is paramount to raise the awareness among health providers, as well as among families and patients, to identify at–risk patients early, and to offer appropriate counseling and treatment if necessary. Providers should educate patients and families to make sustainable healthful lifestyle choices rather than focus on a specific weight–loss goal.”