P-177: Disordered eating risk in adolescents with type 1 diabetes: clinical and metabolic correlates and the discriminative role of HbA1c
J C Acioli, J Araújo, B G S Gomes, T d A Schuler, P M P Ribeiro, A H d A Ferreira, A C d S Vasconcelos, V M G A Feitosa, B P R Martins, M A d J R Albuquerque, A B O Barbosa, C D SousaAbstract
Introduction
Eating disorders (ED) are more prevalent in adolescents with type 1 diabetes (T1D) and are associated with poor glycemic control, acute and chronic complications, and increased morbidity and mortality, yet remain underdiagnosed.
Objectives
To assess ED risk in adolescents with T1D using the Diabetes Eating Problem Survey–Revised (DEPS-R) and identify associated clinical and metabolic factors.
Methods
Cross-sectional study including 108 adolescents (10–18 years) with T1D followed at a tertiary center. ED risk was defined as DEPS-R ≥20. Clinical, laboratory, and sociodemographic data were collected. Bivariate and multivariate analyses, Spearman correlation, and ROC curve analysis were performed.
Results
High ED risk was identified in 41.7% of participants. BMI, total daily insulin dose, and HbA1c were independent predictors (p<0.05). Each 1 kg/m2 increase in BMI was associated with ∼3-fold higher risk; a 0.5 IU/kg increase in insulin dose with 2.36-fold higher risk; and each 1% increase in HbA1c with 1.28-fold higher risk. HbA1c >9.5% showed moderate discrimination (AUC=0.706; sensitivity 68.2%, specificity 63.5%). Comorbidities (p=0.008) and post-pubertal status (p=0.042) were associated with higher risk. No association was observed with sociodemographic variables or diabetes duration. Most participants (87.9%) reported good comprehension of DEPS-R items.
Conclusions
ED risk is high in adolescents with T1D and correlates with poor metabolic control. DEPS-R is a useful screening tool, and HbA1c may help identify high-risk patients, supporting routine screening.