Note: Endonna Ng and Li Pung are joint first authors
Introduction:
Body image distress and problematic eating behaviour can impact glycaemic control in adults with type 1 diabetes mellitus (T1DM).
Aim
To determine prevalence of body image distress, problematic eating and insulin restriction, in patients with T1DM.
Setting:
T1DM diabetes clinic at Fiona Stanley Hospital, a tertiary care hospital in Western Australia.
Methods:
Cross-sectional study, of adults ≥18years with T1DM attending a diabetes clinic. Patients completed the following questionnaires at a single time point: (1) Body Image Concern Inventory (BICI), (2) Body Image-Acceptance and Action Questionnaire (BI-AAQ), (3) Diabetes Eating Problem Survey-Revised (DEPS-R), (4) frequency of diabetes self-care behaviours (Diabetes Care Record), (5) Diabetes Distress Scale Revised (DDS-R), and (6) Patient Health Questionnaire-4 (PHQ-4). Demographic information was obtained from participants’ digital medical records.
Results:
N=129. 70.5% of participants were on multiple daily injections (MDI) and 29.5% on insulin pumps (CSII). Mean age 34yrs, diabetes duration 15.5yrs, HbA1c 8.42%, and BMI 26. Body image distress was higher in the CSII compared to those on MDI regimens (p<0.01). 30.2% reported both body image distress and problematic eating as determined by BICI and DEPSR. 58.1% identified mainly problematic eating. 11.6% reported no/low body image distress and/or eating problems. Participants reporting no/low body image distress and/or eating problems had lower mean BMI (22.60±3.16) compared to those reporting eating problems (25.91±4.41, p=0.041), and those with both body image distress and eating problems (27.51±5.18, p=0.003).
Conclusions:
Body image distress and problematic eating behaviours are prevalent in T1DM. The results highlight the importance of screening to identify and offer patients appropriate multidisciplinary interventions to possibly prevent disordered eating and worsening glycaemic control.