ESPEYB16 10. Type 1 Diabetes Mellitus (1) (20 abstracts)
10.15. Increased prevalence of disordered eating in the dual diagnosis of type 1 diabetes mellitus and celiac disease
Tokatly Latzer I , Rachmiel M , Zuckerman Levin N , Mazor-Aronovitch K , Landau Z , Ben-David RF , GrafBar-El C , Gruber N , Levek N , Weiss B , Stein D , Lerner-Geva L & Pinhas-Hamiel O
Department of Pediatrics A, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Ramat-Gan; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
To read the full abstract: Pediatr Diabetes. 2018;19:749–755.
Disordered eating behaviors (DEBs) may lead to full blown eating disorders and these might impair patients’ adherence to chronic disease management. Both type 1 diabetes mellitus (T1DM) and celiac disease (CD) are associated with DEBs. Adolescents with T1D and eating disorders have worse metabolic control and a higher rate of acute complications than T1D patients without DEBs (1).
This study from Tel Aviv, Israel examined the risk of DEBs in adolescents and young adults with a dual diagnosis of T1DM and CD, compared to individuals with only one of diagnosis.
Individuals with both T1DM and CD (T1DM+CD, n=39), T1DM-only (n=97) or CD-only (n=267) completed the Eating Attitude Test-26 (EAT-26) questionnaire. Those with T1DM also completed the Diabetes Eating Problem Survey-Revised (DEPS-R). There were no differences between groups in sex, age, HbA1c, age of disease diagnosis and duration.
The prevalence of DEBs was 3-fold higher in the T1DM+CD group (26.0%) than T1DM-only (8.2%) and CD-only (8.2%) groups (P=0.003), and in both females and males separately. In models adjusted for age, sex, and BMI, the T1DM+CD group had a higher risk for DEBs (odds ratio: 4.7, 95% CI: 1.9–11.2, P=0.001). Additionally, and as previously described (1) being female, older and overweight increased the risk for DEBs. Other studies from other centers have shown a clear relationship between higher HbA1c values and DEBs risk, but this was not seen here.
As might have been expected, individuals with both T1DM and CD have an increased likelihood to develop DEBs. It is mandatory to screen for the presence of eating disorders in patients with T1D and even more so in T1D patients who also have CD.
Reference: 1. Reinehr T, Dieris B, Galler A, Teufel M, Berger G, Stachow R, Golembowski S, Ohlenschläger U, Holder M, Hummel M, Holl RW, Prinz N. Metabolic Control and Dynamics of Weight Status in Adolescent Girls Point to Eating Disorders in the First Years after Manifestation of Type 1 Diabetes Mellitus: Findings from the Diabetes Patienten Verlaufsdokumentation Registry. J Pediatr. 2019 Apr;207:205–212.e5.
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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