Pursey Kirrilly M, Hay Phillipa, Bussey Kay, Trompeter Nora, Lonergan Alexandra, Pike Kathleen M, Mond Jonathon, Mitchison Deborah
1Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 NSW Australia.
2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.
J Eat Disord. 2020 Feb 28;8:5. doi: 10.1186/s40337-020-0282-y. eCollection 2020.
People with diabetes have been shown to be at risk for disordered eating compared to their non-diabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction.
Secondary school students ( = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cut-offs for disordered eating behaviours were generated for analysis.
Disordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; < 0.001), laxative use (diabetes 15.4%, no diabetes 2.1%; < 0.001), use of cigarettes (diabetes 26.9%, no diabetes 4.3%; < 0.001) and other drugs (diabetes 28.9%, no diabetes 4.0%; < 0.001), cleanse/detox (diabetes 30.8%, no diabetes 10.5%; < 0.001) and extreme weight loss diets (diabetes 13.5%, no diabetes 4.7%; < 0.003) were higher in those reporting a diagnosis of diabetes. In addition, 17% of those with diabetes reported frequent insulin restriction (≥ once per week), and insulin restriction was associated with more frequent disordered eating behaviours.
There was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples.
与非糖尿病同龄人相比，糖尿病患者已被证明存在饮食失调风险。然而，大多数研究是在从临床糖尿病患者群体或登记处抽取的相对较小样本中进行的。需要基于社区的样本，以更好地了解该人群中的饮食失调行为。在一项针对澳大利亚青少年的大型社区人群样本研究中，本研究旨在：（1）调查报告患有糖尿病的青少年与非糖尿病同龄人相比的饮食失调行为；（2）测试饮食失调行为与胰岛素限制之间的关联。
中学生（n = 4854；平均（标准差）年龄14.4（1.6）岁；47%为男孩）完成了一项在线调查，包括自我报告的糖尿病情况、人口统计学信息、体重状况、物质使用情况、胰岛素限制和饮食失调行为。生成了饮食失调行为的临床有意义的临界值用于分析。
饮食失调行为，特别是自我催吐（糖尿病患者中为19.2%，非糖尿病患者中为3.3%；P < 0.001）、使用泻药（糖尿病患者中为15.4%，非糖尿病患者中为2.1%；P < 0.001）、吸烟（糖尿病患者中为26.9%，非糖尿病患者中为4.3%；P < 0.001）和使用其他药物（糖尿病患者中为28.9%，非糖尿病患者中为4.0%；P < 0.001）、清洁/排毒（糖尿病患者中为30.8%，非糖尿病患者中为10.5%；P < 0.001）以及极端减肥饮食（糖尿病患者中为13.5%，非糖尿病患者中为4.7%；P < 0.003）在报告患有糖尿病的青少年中更为常见。此外，17%的糖尿病患者报告频繁胰岛素限制（每周≥一次），且胰岛素限制与更频繁的饮食失调行为相关。
与无糖尿病的同龄人相比，糖尿病青少年的饮食失调行为发生率较高。本研究结果可能为未来针对合并糖尿病和饮食失调行为的人群的健康促进、预防和早期干预方法提供信息。未来需要进行纵向研究，以评估基于社区样本的糖尿病患者随时间推移的饮食失调行为。
