Disordered eating behaviors in persons with type 1 diabetes: frequency, risk factors, depressive and anxiety symptoms, and clinical outcomes

Type 1 diabetes (T1D) is associated with significant psychological burden and an elevated prevalence of Disordered Eating Behaviors (DEBs) among persons with T1D (PWT1D). This study examined the frequency of DEBs in PWT1D and investigated their clinical, psychological, and psychiatric aspects, including depressive and anxiety symptoms, as well as glycemic outcomes, in a Brazilian population. A cross-sectional study was conducted from March to July 2022 with adolescents and young adults with T1D (ages 13-39) recruited nationwide in Brazil via social media. Participants completed an online questionnaire, the Diabetes Eating Problem Survey Revised-BR (DEPS-R-BR), and the Hospital Anxiety and Depression scale. Descriptive analyses were performed. Two hundred and seventeen PWT1D met eligibility criteria, eighty-nine % were female, with a mean age 28.5 (SD = 6.83) years and a mean HbA1c 7.4% (SD = 1.7). Sixty-four % scored ≥20 on DEPS-R-BR. DEBs risk (DEPS-R-BR ≥20) was associated with fixed insulin dosing (p = .035), higher anxiety (p < .001), having a family member with an eating disorder (EDs) (p = .039. Higher DEPS-R-BR scores were associated with insulin restriction and omission (p < .001), depressive symptoms (p < .001), higher BMI (p = .007), higher HbA1c (p = 0.001), and female sex (p < .001). In this sample of PWT1D, DEBs were common and aligned with adverse psychological profiles and suboptimal clinical markers. Routine screening for DEBs risk detection is crucial for timely therapeutic interventions.