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1型糖尿病青少年的饮食行为紊乱:关于诊断挑战的探索性研究

Disturbed Eating Behaviors in Youth with Type 1 Diabetes: An Exploratory Study about Challenges in Diagnosis.

作者信息

Calcaterra Valeria, Mazzoni Chiara, Ballardini Donatella, Tomba Elena, Zuccotti Gian Vincenzo, Mameli Chiara, De Giuseppe Rachele, Cena Hellas

机构信息

Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy.

Department of Pediatrics, "Vittore Buzzi" Children's Hospital, 20157 Milano, Italy.

出版信息

Diagnostics (Basel). 2020 Dec 3;10(12):1044. doi: 10.3390/diagnostics10121044.

Abstract

Disordered eating behaviors (DEBs), including diagnosable eating disorders, are quite common and can interfere with optimal type 1 diabetes (T1DM) management. We explored DEBs prevalence in youth with T1DM, proposing news diagnostic subscales, to represent the clinical dimensions associated with feeding and eating disorders (ED); Methods: additionally to SCOFF questionnaire and Diabetes Eating Problem Survey-Revised (DEPS-R), four subscales combined from the original DEPS-R questionnaire were administered to 40 youths with T1DM (15.0 ± 2.6); Results: females showed higher scores than males in DEPS-R original factor 2 ("preoccupations with thinness/weight", = 0.024) and in DEPS-R proposed "restriction" factor ( = 0.009). SCOFF scores was correlated with original DEPS-R factors 1 ("maladaptive eating habits") and 2 ( < 0.001) and with the newly proposed DEPS-R factors: restriction, disinhibition, compensatory behaviors, diabetes management (all < 0.02). Diabetes management was the only factor related to glycated hemoglobin level ( = 0.006). Patients with high DEPS-R score (≥20) scored higher than patients with low (<20) DEPS-R score in DEPS-R original factors 1 ( < 0.001) and 2 ( = 0.002) as well as in the proposed factors including restriction, disinhibition, diabetes management (all < 0.02); Conclusions: the complicated nature of DEBs calls for the development target specific questionnaires to be used as screening tools to detect cases of DEBs and exclude non cases. Early recognition of DEBs in adolescents with T1DM is essential for effective prevention and successful treatment.

摘要

饮食失调行为(DEB),包括可诊断的饮食失调症,相当常见,并且会干扰1型糖尿病(T1DM)的最佳管理。我们探讨了T1DM青少年中DEB的患病率,提出了新的诊断子量表,以代表与喂养和饮食失调(ED)相关的临床维度;方法:除了SCOFF问卷和糖尿病饮食问题调查修订版(DEPS-R)外,还对40名T1DM青少年(15.0±2.6)进行了由原始DEPS-R问卷组合而成的四个子量表的测试;结果:女性在DEPS-R原始因子2(“对消瘦/体重的过度关注”,P = 0.024)和DEPS-R提议的“限制”因子(P = 0.009)上的得分高于男性。SCOFF得分与原始DEPS-R因子1(“适应不良的饮食习惯”)和2(P<0.001)以及新提议的DEPS-R因子:限制、去抑制、代偿行为、糖尿病管理(均P<0.02)相关。糖尿病管理是与糖化血红蛋白水平相关的唯一因子(P = 0.006)。DEPS-R得分高(≥20)的患者在DEPS-R原始因子1(P<0.001)和2(P = 0.002)以及包括限制、去抑制、糖尿病管理在内的提议因子上的得分均高于DEPS-R得分低(<20)的患者(均P<0.02);结论:DEB的复杂性要求开发针对性的问卷作为筛查工具,以检测DEB病例并排除非病例。早期识别T1DM青少年中的DEB对于有效预防和成功治疗至关重要。

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