Testing an integrated model of eating disorders in paediatric type 1 diabetes mellitus.

ABSTRACT

BACKGROUND: Eating disorders in young people with type 1 diabetes mellitus confer additional health risks beyond those conferred by the disease itself. Risk factors for developing eating disorders are poorly understood. OBJECTIVE: The current study aimed to examine risk factors for eating disturbance in young people with type 1 diabetes mellitus. Both diabetes specific risk factors, such as body mass index (BMI), glycaemic control and diabetes-related conflict, and also more general risk factors such as dysfunctional perfectionism and low self-esteem were assessed. METHODS: Fifty young people aged 14-16 and their primary caregiver were asked to complete interviews and questionnaires about their eating attitudes and behaviours, dysfunctional perfectionism, self-esteem, family conflict, and general mental health symptoms. Recent weight and height and glycaemic control were extracted from the medical file. RESULTS: Different factors distinguished those young people who displayed eating disorder attitudes from those who did not (higher BMI-z, poorer glycaemic control, and lower self-esteem) and those young people who displayed eating disorder behaviour from those who did not (lower self-esteem and higher diabetes-related family conflict). CONCLUSIONS: The results of the current study suggest that there might be different factors associated with eating disorders (ED) attitudes and ED behaviours, but that food/eating-related factors, family factors, and intra-personal factors are all important. Furthermore there are some gender differences in the presence of ED attitudes and behaviours and preliminary evidence that higher body mass indexes (BMIs) impact on girls more than they do on boys.