title: Disordered eating behaviors in youth with type 1 diabetes: prospective pilot assessment following initiation of insulin pump therapy.
abstract: BACKGROUND
  There is risk for disordered eating behaviors in type 1 diabetes, especially related to insulin manipulation. Implementation of insulin pump therapy may encourage either normalization of eating behaviors or a greater focus on food intake due to renewed emphasis on carbohydrate counting. There is need for prospective studies to assess disordered eating behaviors upon implementation of pump therapy using diabetes-specific measurement tools.
  
  
  METHODS
  In a multicenter pilot study, 43 youth with type 1 diabetes, 10-17 years old, were assessed prior to pump initiation and after 1 and 6 months of pump therapy. Youth completed the Diabetes-specific Eating Problems Survey-Revised (DEPS-R), a validated measure of risk for both diabetes-specific and general disordered eating behaviors.
  
  
  RESULTS
  Youth (45% female), 13.3 years old with diabetes for 2.1 years, had a mean hemoglobin A1c of 8.3±1.3% (68±14.5 mmol/mol) at baseline. DEPS-R scores decreased over time (P=0.01). Overall rate of high risk for eating disorders was low. Overweight/obese youth endorsed more disordered eating behaviors than normal-weight participants. DEPS-R scores were correlated with z-score for body mass index at all three time points and with hemoglobin A1c after 1 and 6 months. Hemoglobin A1c did not change significantly over the 6 months and was higher in overweight/obese compared with normal-weight participants.
  
  
  CONCLUSIONS
  Initiation of insulin pump therapy was associated with diminished endorsement of disordered eating behaviors in youth with type 1 diabetes. Longer follow-up studies are needed to assess the impact of insulin pump therapy on glycemic control, weight status, and disordered eating behaviors in this vulnerable population.
authors.affiliation: Pediatric, Adolescent, & Adult Section, Section on Genetics & Epidemiology, Joslin Diabetes Center, Boston, MA 02215, USA.
authors.forename: Jessica T
authors.initials: JT
authors.lastname: Markowitz
authors.forename: Cielo A
authors.initials: CA
authors.lastname: Alleyn
authors.forename: Roxanne
authors.initials: R
authors.lastname: Phillips
authors.forename: Andrew
authors.initials: A
authors.lastname: Muir
authors.forename: Deborah
authors.initials: D
authors.lastname: Young-Hyman
authors.forename: Lori M B
authors.initials: LM
authors.lastname: Laffel
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001294:Attitude to Health; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D001828:Body Image; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D005247:Feeding Behavior / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007332:Insulin Infusion Systems / Q000523:psychology; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose
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