Disordered eating behaviors in youth and young adults with type 1 or type 2 diabetes receiving insulin therapy: the SEARCH for Diabetes in Youth Study
Open accessAbstract
OBJECTIVE This study examines the prevalence of disordered eating behaviors (DEB) and its associations with glycemic control, insulin sensitivity (IS), and psychosocial functioning in a large, diverse cohort of youth and young adults with type 1 or type 2 diabetes. RESEARCH DESIGN AND METHODS In the SEARCH for Diabetes in Youth study, 2,156 youth and young adults with type 1 diabetes (mean ± SD age 17.7 ± 4.3 years; 50.0% female) and 149 youth and young adults with type 2 diabetes (age 21.8 years ± 3.5; 64.4% female) who were receiving insulin therapy completed the Diabetes Eating Problem Survey–Revised (DEPS-R), a self-reported measure for identifying disordered eating. DEB were defined as a DEPS-R score ≥20. Demographic characteristics, clinical measures, and health behaviors of participants with DEB and those without DEB were compared by using t tests. RESULTS DEB were observed in 21.2% of participants with type 1 diabetes and 50.3% of participants with type 2 diabetes. Participants encountered challenges in maintaining a healthy weight while controlling their diabetes. For both types of diabetes, individuals with DEB had a significantly higher BMI z score, lower insulin sensitivity, more depressive symptoms, and poorer quality of life than those without DEB. Diabetic ketoacidosis episodes occurred more frequently in youth with type 1 diabetes with DEB compared to those without DEB. CONCLUSIONS These findings highlight that DEB are prevalent among youth and young adults with type 1 and type 2 diabetes and who are receiving insulin therapy, and DEB are associated with poorer clinical outcomes and psychosocial well-being. Heightened awareness and early interventions are needed to address DEB for this at-risk population, as are longitudinal studies evaluating the course of DEB and diabetes outcomes.
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Rigid meal plans may be contraindicated for individuals who are at increased risk of clinically significant maladaptive eating behaviors.
“For example, caloric restriction may be essential for glycemic management and weight maintenance, but rigid meal plans may be contraindicated for individuals who are at increased risk of clinically significant maladaptive eating behaviors (118).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [118]
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- Authors
- Nip, A. S. Y., Reboussin, B. A., Dabelea, D., Bellatorre, A., Mayer-Davis, E. J., Kahkoska, A. R., Lawrence, J. M., Peterson, C. M., Dolan, L., & Pihoker, C.
- Affiliations
- University of Washington (US)
- Wake Forest University Health Sciences (US)
- Colorado School of Public Health (US)
- Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill, NC
- University of North Carolina at Chapel Hill (US)
- Kaiser Permanente (US)
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Pihoker, Catherine
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2019-03-12
- Volume
- 42
- Issue
- 5
- Pages
- 859-866
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC6489106
- OpenAlex
- W2921461134
- Cited by
- 145
- References
- 45
- Citations by year
- 2026: 13 · 2025: 26 · 2024: 19 · 2023: 25 · 2022: 24 · 2021: 21 · 2020: 13 · 2019: 3
- FWCI
- 17.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (00097, DP-05-069, DP-10-001)
- National Institute of Diabetes and Digestive and Kidney Diseases (1UC4DK108173)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- disordered eating, type 1 diabetes, type 2 diabetes, insulin therapy, youth and young adults, glycemic control, insulin sensitivity, depressive symptoms, quality of life, diabetic ketoacidosis, body mass index, SEARCH for Diabetes in Youth
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Blood Glucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Feeding Behavior, Female, Humans, Insulin, Male, Quality of Life, Surveys and Questionnaires, Risk Factors, United States, Cohort Studies, Prevalence, Diabetic Ketoacidosis, Young Adult
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