Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Prevalence of disordered eating in adults with type 1 diabetes mellitus attending the royal melbourne hospital diabetes service (#235)

Andrea Bramley 1 2 , Arleen Watt 2 , Ashley Sandison 2 , Alexandra Gorelik 2
  1. Discipline of Dietetics and Human Nutrition; Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Vic, Australia
  2. Royal Melbourne Hospital, Parkville, VIC, Australia

Disordered eating is common among adults with Type 1 diabetes mellitus (T1DM) and is associated with increased morbidity and mortality (1). The aim of this study is to establish the prevalence of disordered eating behaviour (DEB) in adults with T1DM attending the Melbourne Health Diabetes Service. Adults aged 18-65 with T1DM attending the service were invited to complete the DEPS - R (2). A total of 199 participants completed the DEPS-R, with 31.2% obtaining a score of ≥ 20, indicating DEB. A DEPS-R ≥ 20 was associated with being female (39% vs 23.3%, p=0.016), a high BMI (28.3kg/m2 (SD ±5.9) vs 25.9 kg/m2 (±4.6 p=0.005) and a high HbA1c (mean 9.3% SD ±2.1 vs 8.1% SD ±1.6, p<0.001). The prevalence of DEB increased significantly with BMI, from 21.3% (BMI <24.9kg/m2) group to 37.1% (BMI>25/m2) group (p=0.02). Low levels of risky behaviour i.e insulin omission (4.8-11.3%), binge eating (11.3%) or purging (1.6%) were observed. However participants with a DEPS-R ≥20 identified behaviours such as  desire to lose weight ( 82%), irregular meal patterns (38.1%), eating more when alone (59%) and reported having difficulty controlling weight and diabetes simultaneously (80.6%). A significant correlation was identified between increasing BMI and desired weight loss (p < 0.001), increase food intake alone ( p= 0.017), and controlling diabetes and weight simultaneously (p=0.003). A DEPS-R ≥ 20 was mostly driven questions regarding a desire to lose weight, meal patterns and glycaemic control. Weight loss may be desirable in older patients with higher BMI suggesting reduced sensitivity of the DEPS-R in adults compared to adolescent populations. All patients with diagnosed pre-existing ED had scores ≥ 20 confirming specificity. The interaction between weight, diabetes control and eating behaviour is complex. Although less sensitive in adults the DEPS-R is a useful tool to identify patients with potential DEB and the need for dietetic intervention.

  1. (1) Scheuing, N., Bartus B., Berger, G., Haberland, H., Icks, A., Knauth, B. 2014.Clinical characteristics and outcome of 467 patients with a clinically recognised eating disorder identified among 52215 patients with Type 1 Diabetes a multicentre German/Austrian Study. Diabetes Care
  2. (2) Markowitz JT, Butler DA, Volkening LK, et al. Brief screening tool for disordered eating in diabetes: internal consistency and external validity in a contemporary sample of paediatric patients with type 1 diabetes. Diabetes Care.