Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus
Abstract Background Adolescents and young adults (AYAs) with diabetes mellitus (DM) are prone to eating disorders that may worsen metabolic control. This study investigated the clinical and behavioral correlates of disordered eating and insulin restriction (DE/IR) behavior and its association with p...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of Eating Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40337-023-00888-8 |
| _version_ | 1797578663256915968 |
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| author | Wei-Chih Chou Yen-Yin Chou Yu-Wen Pan Tsung-Ying Ou Meng-Che Tsai |
| author_facet | Wei-Chih Chou Yen-Yin Chou Yu-Wen Pan Tsung-Ying Ou Meng-Che Tsai |
| author_sort | Wei-Chih Chou |
| collection | DOAJ |
| description | Abstract Background Adolescents and young adults (AYAs) with diabetes mellitus (DM) are prone to eating disorders that may worsen metabolic control. This study investigated the clinical and behavioral correlates of disordered eating and insulin restriction (DE/IR) behavior and its association with psychological health among AYAs with DM. Methods We enrolled patients with DM aged 10–30 years receiving insulin treatment in a tertiary medical center from 2019 to 2021. After obtaining informed consent, we assessed various visit-to-visit HbA1c measures indicating glycemic control, DE/IR behavior using the modified SCOFF questionnaire, weight-control practices (e.g., self-medication, induced vomiting, and over-exercising), and anxious and depressive symptoms using the Hospital Anxiety and Depression Scale. Correlation and hierarchical regression analyses were applied to understand the clinical and behavioral correlates of DE/IR behavior and its association with anxiety and depression. Results Among the 110 patients with type 1 and type 2 DM recruited, we found 17.6% restricting insulin use and 6.3% self-medicating for weight control (higher in type 2 DM than type 1 DM). Hierarchical regression analyses showed HbA1c standard deviation (odds ratio = 2.18, [95% confidence interval 1.07–4.42]), body image (1.83, [1.05–3.20]), and dieting (4.74, [1.70–13.23]) associated with DE/IR behavior. Moreover, DE/IR behavior was further associated with anxiety (1.17 [1.08–1.27]) and depression (1.12 [1.03–1.22]). Conclusion DE/IR behavior is not uncommon among AYAs with DM, particularly those with type 2 DM, and may be associated with anxiety and depressive symptoms. In addition, HbA1c variability is correlated with DE/IR behavior, and the clinical implications need further exploration. |
| first_indexed | 2024-03-10T22:25:01Z |
| format | Article |
| id | doaj.art-47bc89c352044cac9d7926810abf2c6d |
| institution | Directory Open Access Journal |
| issn | 2050-2974 |
| language | English |
| last_indexed | 2024-03-10T22:25:01Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Eating Disorders |
| spelling | doaj.art-47bc89c352044cac9d7926810abf2c6d2023-11-19T12:07:42ZengBMCJournal of Eating Disorders2050-29742023-09-011111810.1186/s40337-023-00888-8Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitusWei-Chih Chou0Yen-Yin Chou1Yu-Wen Pan2Tsung-Ying Ou3Meng-Che Tsai4Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDivision of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDivision of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Genomic Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDivision of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityAbstract Background Adolescents and young adults (AYAs) with diabetes mellitus (DM) are prone to eating disorders that may worsen metabolic control. This study investigated the clinical and behavioral correlates of disordered eating and insulin restriction (DE/IR) behavior and its association with psychological health among AYAs with DM. Methods We enrolled patients with DM aged 10–30 years receiving insulin treatment in a tertiary medical center from 2019 to 2021. After obtaining informed consent, we assessed various visit-to-visit HbA1c measures indicating glycemic control, DE/IR behavior using the modified SCOFF questionnaire, weight-control practices (e.g., self-medication, induced vomiting, and over-exercising), and anxious and depressive symptoms using the Hospital Anxiety and Depression Scale. Correlation and hierarchical regression analyses were applied to understand the clinical and behavioral correlates of DE/IR behavior and its association with anxiety and depression. Results Among the 110 patients with type 1 and type 2 DM recruited, we found 17.6% restricting insulin use and 6.3% self-medicating for weight control (higher in type 2 DM than type 1 DM). Hierarchical regression analyses showed HbA1c standard deviation (odds ratio = 2.18, [95% confidence interval 1.07–4.42]), body image (1.83, [1.05–3.20]), and dieting (4.74, [1.70–13.23]) associated with DE/IR behavior. Moreover, DE/IR behavior was further associated with anxiety (1.17 [1.08–1.27]) and depression (1.12 [1.03–1.22]). Conclusion DE/IR behavior is not uncommon among AYAs with DM, particularly those with type 2 DM, and may be associated with anxiety and depressive symptoms. In addition, HbA1c variability is correlated with DE/IR behavior, and the clinical implications need further exploration.https://doi.org/10.1186/s40337-023-00888-8Diabetes mellitusDisordered eating behaviorInsulin restrictionDepressionAnxiety |
| spellingShingle | Wei-Chih Chou Yen-Yin Chou Yu-Wen Pan Tsung-Ying Ou Meng-Che Tsai Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus Journal of Eating Disorders Diabetes mellitus Disordered eating behavior Insulin restriction Depression Anxiety |
| title | Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus |
| title_full | Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus |
| title_fullStr | Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus |
| title_full_unstemmed | Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus |
| title_short | Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus |
| title_sort | correlates of disordered eating and insulin restriction behavior and its association with psychological health in taiwanese youths with diabetes mellitus |
| topic | Diabetes mellitus Disordered eating behavior Insulin restriction Depression Anxiety |
| url | https://doi.org/10.1186/s40337-023-00888-8 |
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