Köprülü Özge, Tan Hülya, Erbaş İbrahim Mert, Şimşek Fatma Yavuzyılmaz, Uyar Nilüfer, Karataş Murat Çağlar, Nalbantoğlu Özlem, Korkmaz Hüseyin Anıl, Özkan Behzat
Department of Pediatric Endocrinology, Dr. Behçet Uz Children's Education and Research Hospital, 35210 Izmir, Turkey.
Department of Pediatrics, İzmir Faculty of Medicine, University of Health Sciences, 35210 Izmir, Turkey.
Medicina (Kaunas). 2025 Sep 2;61(9):1585. doi: 10.3390/medicina61091585.
: Eating disorders are one of the most widespread health concerns, mainly among adolescents. Children and adolescents with type 1 diabetes mellitus (T1DM) have been reported to have a high prevalence of eating disorders. The aim of our study is to evaluate the risk of diabetes-specific eating disorders in children with T1DM using continuous subcutaneous insulin infusion (CSII), with real-time glycemic data from continuous glucose monitoring (CGM). : Sixty-four patients (aged 7-18 years) completed the Diabetes Eating Problem Survey-Revised (DEPS-R). The DEPS-R is a diabetes-specific self-report questionnaire to assess diabetes-specific compensatory behaviors. Auxological findings, sex, age, age at diagnosis, hemoglobin A1c (HbA1c) levels, and all CGM data were obtained from their medical records. : Although the median DEPS-R score was higher in children and adolescents using CSII compared to those using multiple daily injections (MDIs) (14 vs. 11), the difference was not statistically significant ( = 0.302). The risk of diabetes-specific eating disorders was identified in six patients (30%) using CSII and in nine patients (20.4%) using multiple daily injections ( = 0.403). Interestingly, in the subgroup with poor glycemic control (HbA1c > 9%), DEPS-R scores were significantly lower among those using CSII compared to the MDI group. Pearson correlation analysis demonstrated positive associations between DEPS-R scores and diabetes duration, weight SDS, body mass index (BMI), BMI SDS, HbA1c, mean glucose, Glucose Management Indicator (GMI), time above range (TAR) (very high), and coefficient of variation (CV), while a moderate negative correlation was observed with time in range (TIR). : This study showed that the treatment of CSII had a beneficial effect on the risk of eating disorders in patients with poor glycemic control. As well, from this perspective, CSII maintains its status as a potentially beneficial therapeutic approach in diabetes management.
饮食失调是最普遍的健康问题之一,主要发生在青少年中。据报道,1型糖尿病(T1DM)患儿和青少年中饮食失调的患病率很高。我们研究的目的是使用持续皮下胰岛素输注(CSII)以及连续血糖监测(CGM)的实时血糖数据,评估T1DM患儿发生糖尿病特异性饮食失调的风险。64名年龄在7至18岁的患者完成了修订版糖尿病饮食问题调查(DEPS-R)。DEPS-R是一份针对糖尿病的自我报告问卷,用于评估糖尿病特异性代偿行为。人体测量学结果、性别、年龄、诊断年龄、糖化血红蛋白(HbA1c)水平以及所有CGM数据均从他们的病历中获取。尽管与使用多次皮下注射(MDIs)的儿童和青少年相比,使用CSII的儿童和青少年的DEPS-R中位数得分更高(分别为14和11),但差异无统计学意义(P = 0.302)。使用CSII的6名患者(30%)和使用多次皮下注射的9名患者(20.4%)被确定有糖尿病特异性饮食失调的风险(P = 0.403)。有趣的是,在血糖控制不佳(HbA1c > 9%)的亚组中,与MDI组相比,使用CSII的患者DEPS-R得分显著更低。Pearson相关分析表明,DEPS-R得分与糖尿病病程、体重标准差评分(SDS)、体重指数(BMI)、BMI SDS、HbA1c、平均血糖、血糖管理指标(GMI)、高于目标范围时间(TAR,非常高)以及变异系数(CV)呈正相关,而与血糖达标时间(TIR)呈中度负相关。这项研究表明,CSII治疗对血糖控制不佳的患者发生饮食失调的风险有有益影响。同样,从这个角度来看,CSII在糖尿病管理中仍保持其作为一种潜在有益治疗方法的地位。