Natural history and predictors of disturbed eating behaviour in girls with Type 1 diabetes.
OBJECTIVE
To determine the natural history and psychosocial predictors of disturbed eating behaviour in girls with Type 1 diabetes (T1D) over a 1-year period.


METHODS
One hundred and six girls with T1D, 9-13 years of age at Time 1, completed a Children's Eating Disorder Examination (cEDE) interview at Time 1 and again 1 year later (Time 2). Potential Time 1 predictors of Time 2 disturbed eating behaviour were body mass index (BMI), self-esteem, depressive symptoms, attachment to parents, and parental eating attitudes. Glycated haemoglobin (HbA(1c)) was measured.


RESULTS
Disturbed eating behaviour was reported by 14% (15/106) of girls at Time 1, and 17% (18/106) at Time 2, and persisted in 8/15 girls over 1 year. Lower self-esteem, higher BMI and more disturbed maternal eating attitudes at Time 1 accounted for 35% of the variance in Time 2 cEDE score, while higher BMI and more disturbed attachment to one's mother predicted new-onset disturbed eating behaviour at Time 2. Glycaemic control was not associated with or predicted by disturbed eating behaviour.


CONCLUSIONS
There was only moderate stability in disturbed eating behaviour status over a 1-year period. In this preliminary study, disturbed eating behaviour was associated with and, to a lesser degree, predicted by physical, psychological and family factors. Although the long-term clinical course of the mild disturbances identified is not known, prevention and early intervention efforts in this high-risk medical group should begin in the pre-teen years, and should probably target multiple factors in order to prevent the persistence and worsening of disturbed eating behaviour and its medical sequelae.
Colton
P A
PA
University Health Network, Toronto, ON, Canada. patricia.colton@uhn.on.ca
Olmsted
M P
MP
Daneman
D
D
Rydall
A C
AC
Rodin
G M
GM
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015995:Prevalence; D012307:Risk Factors
D001786:Blood Glucose