Disturbed eating behaviors in adolescents with type 1 diabetes. How to screen for yellow flags in clinical practice?

Minke M. A. Eilander*, Maartje de Wit, Joost Rotteveel, Henk Jan Aanstoot, Willie M. Bakker-van Waarde, Euphemia C. A. M. Houdijk, Roos Nuboer, Per Winterdijk, Frank J. Snoek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)
74 Downloads (Pure)

Abstract

Background: Adolescents with type 1 diabetes are at an increased risk of disturbed eating behaviors (DEBs).

Objective: The aims of this study are to (i) explore the prevalence of DEBs and associated yellow flags', and (ii) establish concordance between adolescents-parents and adolescents-clinicians with respect to DEBs.

Methods: Adolescents (11-16yr) and parents completed questionnaires. A stepwise approach was used to assess DEBs: only adolescents whose answers raised psychological yellow flags for DEBs completed the Diabetes Eating Problems Scale-Revised and questions from the AHEAD study. Parents and clinicians shared their observations regarding possible DEBs. Kruskal-Wallis tests, post hoc Mann-Whitney U test, and chi-squared tests were utilized to examine clinical yellow flags. Cohen's kappa was used to assess concordance.

Results: Of 103 adolescents participated (51.5% girls), answers of 47 (46.5%) raised psychological yellow flags, indicating body and weight concerns. A total of 8% scored above cut-off for DEBs. Clinical yellow flags were elevated glycated hemoglobin A1c (p=0.004), older age (p=0.034), dieting frequency (p=0.001), reduced quality of life (p=0.007), less diabetes self-confidence (p=0.015), worsened diabetes management (p

Discussion: Half of the adolescents reported body and weight concerns, less than 1 in 10 reported DEBs. Screening for yellow flags for DEBs as a part of clinical routine using a stepwise approach and early assistance is recommended to prevent onset or deterioration of DEBs.

Original languageEnglish
Pages (from-to)376-383
Number of pages8
JournalPediatric Diabetes
Volume18
Issue number5
DOIs
Publication statusPublished - Aug-2017

Keywords

  • adolescents
  • DINO study
  • disturbed eating behavior
  • quality of life
  • type 1 diabetes
  • QUALITY-OF-LIFE
  • WEIGHT CONTROL
  • DISORDERS
  • MELLITUS
  • WOMEN
  • ATTITUDES
  • INSULIN
  • PSYCHOEDUCATION
  • OUTCOMES
  • FEMALES

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