2805-LB: Clinic-Based Eating Disorder Prevention Program in Young Women with Type 1 Diabetes: Effects of the Australian Diabetes Body Project RCT

Introduction and Objective: Young women with type 1 diabetes (T1D) have a high prevalence of eating disorder (ED), resulting in suboptimal glycemia, early diabetes complications and mortality. Few ED prevention interventions have been evaluated in T1D and none have demonstrated significant metabolic benefit. To evaluate the effectiveness of the novel virtually-delivered peer-facilitated Australian Diabetes Body Project (ADBP), a cognitive-dissonance-based ED prevention program, in a clinic setting. Methods: Women with T1D aged 15-30 years were randomized to ADBP or active control of educational videos. ADBP comprised of 6-weekly, 1-hour, virtual, group sessions co-facilitated by a clinician and a T1D peer. Primary outcome was body dissatisfaction (BDS), secondary outcomes were thin-ideal internalization (IBSS-R), ED symptoms (EDEQ), diabetes-specific disordered eating behaviors (DEPS-R), HbA1c and CGM metrics at baseline (T1), post-intervention (T2), 3-month follow-up (T3). Glycemic outcomes were extracted from medical records. Analyses used REML mixed-effects models (ITT). Results: Eighty-five participants were randomized (Control n=43; ADBP n=42). Whilst no significant between-group differences were observed, both groups showed significant within-group improvements in BDS, IBSS-R and EDEQ from T1 to T2 and T3 (all p<0.001). DEPS-R reductions were larger in ADBP (-7.40 at T2/T3, p<0.001) than Control (-3.47 to -5.02, p=0.029-0.002). A significant between-group difference in HbA1c at T3 favored ADBP (adjusted mean difference -1.05%, 95% CI -1.62 to -0.48, p<0.001). Time-in-range and time-above-range improved more in ADBP, though nonsignificantly. Conclusion: A clinic-delivered ED prevention program for young women with T1D improved ED risks/symptoms and produced a clinically meaningful and significant HbA1c reduction, suggesting ADBP also improves metabolic outcomes. These ground-breaking findings have great implications for all Diabetes Services. Disclosure N. D'Silva: None. N.S. Sandoval: None. S.N. Gannon: None. E. Stice: None. L. Wisting: None. S.E. Bartlett: None. J.V. Jones: None. L.K. Phillips: None. C. Hendrieckx: None. Funding Mater Foundation - Betty McGrath Grant (3300)