P-294: Disordered eating behaviors among adolescents with type 1 diabetes treated with multiple daily injections, insulin pumps and automated insulin delivery systems
S Yalçın Yılmaz, M Erturk Beyter, G Demir, D Gökşen, Y Atik AltınokAbstract
Introduction
Disordered eating behaviours(DEBs) are a concern in adolescents with type 1 diabetes(T1D). In this population, DEBs are associated with poorer glycaemic control, diabetic ketoacidosis, complications and lower quality of life.
Objectives
To evaluate the associations of insulin delivery modalities with DEBs and diabetes-specific nutrition knowledge and to examine their associations with glycaemic outcomes
Methods
Participants’ risk of DEBs was assessed using the Diabetes Eating Problem Survey-Revised(DEPS-R), with total scores ranging from 0 to 80; scores of ≥20 were considered indicative of diabetes-specific disordered eating risk.
Results
A total of 179 adolescents with T1D were included; 50.3% were girls. Mean age was 14.30±2.75 years, and median HbA1c was 7.7(1.5)%. There were no gender differences in age, diabetes duration, age at diagnosis, BMI z-score, HbA1c, or glycaemic metrics (p>0.05).Overall, 62% were using multiple daily injections(MDI)(n=111),10.6% insulin pump therapy (n=19), and 27.4% automated insulin delivery(AID)(n=49).Total DEPS-R scores were similar by gender, but girls had higher DEPS-R subfactor 2 scores, indicating greater concern about thinness and body weight(p<0.0001).Overall, 24.6% had DEB risk(DEPS-R ≥20); among them, 54.5% were girls. Adolescents at risk had higher BMI z-scores(p<0.0001), while age, diabetes duration, age at diagnosis, HbA1c, glycaemic metrics, and nutrition knowledge scores were similar.DEPS-R score correlated with BMI z-score(r=0.366, p<0.001).Adolescents using AID had lower HbA1c, TAR, GMI, and CV(p<0.05), and higher TIR(p<0.0001) than those using other modalities, whereas TBR and DEPS-R scores were similar across modalities.
Conclusions
One in four adolescents with T1D was at risk of DEB. Although girls reported greater concern about thinness and body weight, the risk of disordered eating behaviours didn’t differ according to insulin delivery modality. These findings suggest that advanced diabetes technologies don’t directly affect the risk of disordered eating behaviours.