What question did this study set out to answer?

The research aims to assess the incidence, prevalence, and mortality rates of anorexia nervosa among individuals with childhood-onset type 1 diabetes compared to controls.

February 14, 2026Open Access

Incidence, prevalence and mortality of anorexia nervosa in individuals with childhood-onset type 1 diabetes: a nationwide retrospective cohort study in Sweden

Key Points

The research aims to assess the incidence, prevalence, and mortality rates of anorexia nervosa among individuals with childhood-onset type 1 diabetes compared to controls.
Nationwide retrospective cohort study using registry data from Sweden covering 1977–2019.
Analysis involved 12,202 individuals diagnosed with type 1 diabetes before age 15 and 48,484 matched controls.
Outcomes based on diagnoses identified via the National Patient Register.
Statistical methods included OR estimation and Kaplan-Meier analysis.
Females with type 1 diabetes had a period prevalence of 1.9% for anorexia nervosa compared to 1.1% in controls.
Ten-year incidence rate was 74.7 cases per 100,000 person-years in females with type 1 diabetes versus 45.2 in controls.
Point prevalence at age 15 years was higher in females with type 1 diabetes (0.87%) compared to controls (0.53%).
Proportional mortality ratios indicated significant mortality risk for females with both conditions.

Abstract

Objectives To investigate the incidence, prevalence and mortality of anorexia nervosa (AN) among individuals with childhood-onset type 1 diabetes (T1D) compared with matched controls in Sweden. Design Retrospective nationwide cohort study using linked registry data. Setting Nationwide, Sweden; population-based registers (covering the period 1977–2019). Participants 12 202 individuals diagnosed with T1D before age 15 years (5618 females; 6584 males) and 48 484 age-matched, sex-matched and municipality-matched controls without diabetes (23 618 females; 24 866 males). Primary and secondary outcome measures AN diagnoses (International Classification of Diseases-10 codes F50.0 and F50.1) identified via the National Patient Register. Outcomes were period prevalence, point prevalence at ages 15 and 20 years, 10-year incidence rates and proportional mortality ratios (PMR), stratified by sex. ORs and incidence rate ratios (IRR) with 95% CIs were estimated using Mantel-Haenszel methods; Kaplan-Meier analysis compared time to AN diagnosis between groups. Results The period prevalence of AN among females with T1D was 1.9% compared with 1.1% in controls (OR 1.64, 95% CI 1.31 to 2.06; p<0.001). The 10-year incidence rate for females with T1D was 74.7 per 100 000 person-years vs 45.2 per 100 000 person-years in controls (IRR 1.77, 95% CI 1.35 to 2.32). Point prevalence at age 15 years was 0.87% (T1D) vs 0.53% (controls) (IRR 1.65, 95% CI 1.16 to 2.35), and at age 20 years was 1.73% (T1D) vs 1.11% (controls) (IRR 1.55, 95% CI 1.20 to 1.99). The PMR for females with both T1D and AN compared with controls without either condition was 20.4 (95% CI 6.6 to 47.6). Male cases were few (n=4 in the T1D group; n=12 in controls). Conclusions Females with childhood-onset T1D in Sweden have an elevated risk of AN and markedly higher mortality when both conditions are present. Despite the increased relative risk, the absolute risk of AN in females with T1D remained below 2%. These findings support routine screening for eating disorders in the T1D population, particularly among adolescent and young adult females.

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Cite This Study

Sjögren et al. (Sun,) studied this question.

synapsesocial.com/papers/6990112b2ccff479cfe5792c https://doi.org/https://doi.org/10.1136/bmjopen-2025-109015

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