d'Emden Helen, Holden Libby, McDermott Brett, Harris Mark, Gibbons Kristen, Gledhill Anne, Cotterill Andrew
Queensland Diabetes Centre, Mater Health Services, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2013 Apr;49(4):E317-23. doi: 10.1111/jpc.12014. Epub 2012 Dec 2.
To describe the presence and type of disturbed eating behaviours and thoughts in a combined male/female Australian sample of adolescents with type 1 diabetes, and examine the association of eating behaviours and thoughts with glycaemic control as evidenced by high glycosylated haemoglobin levels (HbA1c).
In this cross-sectional descriptive study, 124 adolescents aged 13-18 years were invited to complete three self-administered questionnaires. The Youth Eating Disorder Examination Questionnaire (YEDE-Q) and the Eating Disorder Inventory -3 Risk Composite (EDI-3RC) assessed risk for an eating disorder. The third questionnaire, the Strengths and Difficulties Questionnaire (SDQ) assessed emotional and behavioural concerns. Clinical data were collected from the medical records, routine clinic appointments and the adolescent.
Any disturbed eating behaviour was reported by approximately one-third of participants (32.3%) and was common in females and males (37.9% vs. 25.9%). Binge eating (17.7%), driven exercise (13.0%) and dietary restraint (8.9%) were the most common disturbed eating behaviours, although restraint was not evident in males. Insulin manipulation/omission (5.6%), vomiting (3.3%), laxative (0.8%) or diuretic use (0.8%) were less common. Regression analysis showed a significant association between HbA1c and more disturbed eating behaviours and thoughts which remained significant when adjusted for confounders.
High rates of disturbed eating behaviours and thoughts were seen in this Australian sample of adolescents with type 1 diabetes. High scores on both eating disorder measures were associated with poorer glycaemic control. These results highlight the need to screen for disordered eating in adolescents with type 1 diabetes.
描述澳大利亚1型糖尿病青少年男女混合样本中存在的饮食行为和思维紊乱情况及类型,并研究饮食行为和思维与糖化血红蛋白水平(HbA1c)所反映的血糖控制之间的关联。
在这项横断面描述性研究中,邀请了124名年龄在13 - 18岁的青少年完成三份自填式问卷。青少年饮食失调检查问卷(YEDE - Q)和饮食失调量表-3风险综合版(EDI - 3RC)评估饮食失调风险。第三份问卷,优势与困难问卷(SDQ)评估情绪和行为问题。临床数据从医疗记录、常规门诊预约以及青少年处收集。
约三分之一的参与者(32.3%)报告有任何饮食行为紊乱,在女性和男性中都很常见(37.9%对25.9%)。暴饮暴食(17.7%)、强迫运动(13.0%)和饮食限制(8.9%)是最常见的饮食行为紊乱,不过饮食限制在男性中不明显。胰岛素操纵/遗漏(5.6%)、呕吐(3.3%)、使用泻药(0.8%)或利尿剂(0.8%)则较少见。回归分析显示HbA1c与更多的饮食行为和思维紊乱之间存在显著关联,在对混杂因素进行调整后仍具有显著性。
在这个澳大利亚1型糖尿病青少年样本中,饮食行为和思维紊乱的发生率很高。两种饮食失调测量方法的高分都与较差的血糖控制有关。这些结果凸显了对1型糖尿病青少年进行饮食紊乱筛查的必要性。