The Relationship of Disordered Eating Habits and Attitudes to Clinical Outcomes in Young Adult Females With Type 1 Diabetes

Robert C. Peveler; Kathryn S. Bryden; H. Andrew W. Neil; Christopher G. Fairburn; Richard A. Mayou; David B. Dunger; Hannah M. Turner

doi:10.2337/diacare.28.1.84

Epidemiology/Health Services/Psychosocial Research

The Relationship of Disordered Eating Habits and Attitudes to Clinical Outcomes in Young Adult Females With Type 1 Diabetes

Robert C. Peveler, FRCPSYCH1,
Kathryn S. Bryden, RN2,
H. Andrew W. Neil, FRCP2,
Christopher G. Fairburn, FRCPSYCH3,
Richard A. Mayou, FRCPSYCH3,
David B. Dunger, FRCP4 and
Hannah M. Turner, DCP1

¹Community Clinical Sciences Research Division, School of Medicine, University of Southampton, Southampton, U.K.
²Division of Public Health and Primary Care, University of Oxford, Oxfordshire, U.K.
³Department of Psychiatry, University of Oxford, Oxfordshire, U.K.
⁴Department of Pediatrics, University of Cambridge, Cambridgeshire, U.K.

Address correspondence and reprint requests to Professor Robert Peveler, University Mental Health Group, Royal South Hants Hospital, Southampton, SO14 0YG, U.K. E-mail: rcp{at}soton.ac.uk

Diabetes Care 2005 Jan; 28(1): 84-88. https://doi.org/10.2337/diacare.28.1.84

Article Figures & Tables

Tables

Table 1—

Characteristics of study groups and clinical eating disorders diagnosed at an assessment interview using the EDE

	Adolescents					Young adults
		Baseline	Follow-up	Total	Baseline	Follow-up	Total
n	33	26		54	37
Age (years)	15.3 ± 1.9	23.9 ± 2.0		21.0 ± 2.7	33.1 ± 2.9
Diabetes duration (years)	7.1 ± 2.9	15.7 ± 2.9		8.8 ± 5.3	20.8 ± 5.5
BMI (kg/m²)	22.7 ± 3.7	24.7 ± 2.6		24.6 ± 4.7	27.3 ± 5.0
BMI >25.0 kg/m²	5 (16)	12 (46)		13 (24)	14 (38)
BMI >30.0 kg/m²	2 (6)	2 (8)		4 (7)	8 (22)
HbA_1c (%)	9.7 ± 1.8	9.3 ± 1.9		9.5 ± 2.5	8.8 ± 1.7
EDE dietary restraint	0.60 (0.0–1.20)	1.55 (0.30–2.80)		1.20 (0.0- 3.00)	1.20 (0.0–2.05)
EDE shape concern	0.56 (0.13–1.63)	1.12 (0.59–1.88)		1.25 (0.25–2.94)	2.25 (0.63–3.13)
EDE weight concern	0.80 (0.40–1.55)	1.80 (0.70–2.55)		1.10 (0.40–2.40)	1.40 (0.80–2.40)
Number of cases
AN	0	0	0	0	0	0
BN	0	0	0	1	0	1
BED	0	0	0	3	1	4
EDNOS	1	1	2	2	0	2

BED, binge eating disorder.

Table 2—

Cumulative incidence of eating disorders and features of disordered eating behavior, including all clinical diagnoses from EDE assessment and data from other sources*

	Adolescents					Young adults
		Baseline	Follow-up	Total	Baseline	Follow-up	Total
n	33	26		54	37
AN	0	0	0	1	1	2
BN†	0	1	1	3	1	4
BED	0	0	0	3	1	4
EDNOS‡	0	1	1	1	0	1
Insulin misuse	5 (15)	10 (39)	10 (39)	20 (37)	21 (57)	21 (57)
Vomiting	2 (6)	4 (15)	4 (15)	6 (11)	7 (19)	7 (19)
Laxative use	0 (0)	2 (8)	2 (8)	6 (11)	8 (22)	8 (22)

Data are n (%).
*
↵* Includes patients’ history and clinical notes.
†
↵† Excludes the subject who progressed from AN to BN (young adult).
‡
↵‡ Excludes the two subjects who progressed from EDNOS to BN (one adolescent and one young adult). BED, binge eating disorder.

Table 3—

Cumulative prevalence of microvascular complications*

	Adolescents			Young adults
		Baseline	Follow-up	Baseline	Follow-up
n	33	29	54	49
Background retinopathy	0	5 (17)	7 (13)	17 (35)
Preproliferative retinopathy	0	3 (10)	0	2 (4)
Laser-treated retinopathy	0	5 (17)	1 (2)	16 (33)
Microalbuminuria	0	4 (14)	1 (2)	3 (6)
Proteinuria	0	4 (14)	1 (2)	3 (6)
Dialysis	0	0	0	1 (2) (has since died)
Transplant	0	0	0	2 (4)
Died from renal failure	0	0	0	2 (4)
Peripheral neuropathy	0	1 (3)	0	10 (20)
Autonomic neuropathy	0	0	0	5 (10)
One serious complication only†	0	6 (21)	2 (4)	7 (14)
Two serious complications	0	2 (7)	0	6 (12)
Three or more serious complications	0	1 (3)	0	6 (12)

Data are n (%).
*
↵* Includes data on subjects not reinterviewed where available, including those subjects who died.
†
↵† Serious complications defined as laser-treated retinopathy, preproliferative retinopathy, proteinuria, renal failure, peripheral nephropathy, or autonomic neuropathy.