Neumark-Sztainer Dianne, Patterson Joan, Mellin Alison, Ackard Diann M, Utter Jennifer, Story Mary, Sockalosky Joseph
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454, USA.
Diabetes Care. 2002 Aug;25(8):1289-96. doi: 10.2337/diacare.25.8.1289.
This study examines the prevalence of specific weight control practices/disordered eating behaviors and associations with sociodemographic characteristics, BMI and weight perceptions, family functioning, and metabolic control among adolescent females and males with type 1 diabetes.
The study population included 70 adolescent females and 73 adolescent males with type 1 diabetes who completed the AHEAD (Assessing Health and Eating among Adolescents with Diabetes) survey. Data on BMI and glycosylated hemoglobin (HbA(1c)) were drawn from medical records.
Unhealthy weight control practices were reported by 37.9% of the females and by 15.9% of the males. Among the females, 10.3% reported skipping insulin and 7.4% reported taking less insulin to control their weight. Only one male reported doing either of these behaviors. Weight control/disordered eating behaviors were not associated with age, parental level of education, family structure, or race/ethnicity. Higher levels of weight dissatisfaction tended to be associated with unhealthy weight control/disordered eating; associations with BMI were inconsistent. Family cohesion was negatively associated with disordered eating among females (r = -0.52; P < 0.001) and males (r = -0.41; P < 0.001), but correlations with other measures of family environment (control, independence, and responsibility for diabetes management) were not significant. Correlations between disordered eating and HbA(1c) levels were significant among females (r = 0.33; P < 0.01) and males (r = 0.26; P < 0.05).
Special attention is needed for youth with weight concerns and those from less cohesive families to assist in the development of healthy diabetes management behaviors.
本研究调查了1型糖尿病青少年女性和男性中特定体重控制行为/饮食失调行为的患病率，以及这些行为与社会人口学特征、体重指数（BMI）和体重认知、家庭功能及代谢控制之间的关联。
研究对象包括70名患有1型糖尿病的青少年女性和73名患有1型糖尿病的青少年男性，他们完成了“糖尿病青少年健康与饮食评估”（AHEAD）调查。BMI和糖化血红蛋白（HbA1c）的数据来自医疗记录。
37.9%的女性和15.9%的男性报告有不健康的体重控制行为。在女性中，10.3%报告跳过胰岛素注射，7.4%报告减少胰岛素用量以控制体重。只有一名男性报告有上述行为之一。体重控制/饮食失调行为与年龄、父母教育水平、家庭结构或种族/民族无关。较高程度的体重不满往往与不健康的体重控制/饮食失调有关；与BMI的关联并不一致。家庭凝聚力与女性（r = -0.52；P < 0.001）和男性（r = -0.41；P < 0.001）的饮食失调呈负相关，但与家庭环境的其他指标（糖尿病管理的控制、独立性和责任感）的相关性不显著。饮食失调与HbA1c水平之间的相关性在女性中显著（r = 0.33；P < 0.01），在男性中也显著（r = 0.26；P < 0.05）。
需要特别关注那些关注体重的青少年以及来自家庭凝聚力较低家庭的青少年，以帮助他们养成健康的糖尿病管理行为。
