title: Eating patterns in adolescents with type 1 diabetes: Associations with metabolic control, insulin omission, and eating disorder pathology.
abstract: The purpose of this study was to investigate eating patterns among male and female adolescents with type 1 diabetes (T1D), and the associations with age, zBMI, eating disorder (ED) pathology, intentional insulin omission, and metabolic control.
  
  
  
  The sample consisted of 104 adolescents (58.6% females) with child-onset T1D, mean age of 15.7 years (SD 1.8) and mean zBMI of 0.4 (SD 0.8). The Child Eating Disorder Examination (ChEDE) assessed meal/snack frequency and ED pathology. T1D clinical data was obtained from the Norwegian Childhood Diabetes Registry.
  
  
  
  A significantly lower proportion of females than males (73.8% vs 97.7%) consumed breakfast on a daily basis. Approximately 50% of both genders ate lunch and 90% ate dinner daily. Among females, skipping breakfast was significantly associated with higher global ED psychopathology, shape concerns, self-induced vomiting, binge eating, insulin omission due to shape/weight concerns, and poorer metabolic control. Less frequent lunch consumption was significantly associated with poorer metabolic control. Skipping dinner was significantly associated with older age, higher dietary restraint, eating concerns, self-induced vomiting, and insulin omission. Among males, less frequent consumption of lunch and evening snacks was associated with attitudinal features of ED, including shape/weight concerns and dietary restraint.
  
  
  
  Among adolescents with T1D, irregular or infrequent meal consumption appears to signal potential ED pathology, as well as being associated with poorer metabolic control. These findings suggest the importance of routinely assessing eating patterns in adolescents with T1D to improve detection of ED pathology and to facilitate improved metabolic control and the associated risk of somatic complications.
authors.affiliation: Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Oslo Diabetes Research Centre, Oslo, Norway. Electronic address: line.wisting@ous-hf.no.
authors.forename: Line
authors.initials: L
authors.lastname: Wisting
authors.affiliation: Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway.
authors.forename: Deborah Lynn
authors.initials: DL
authors.lastname: Reas
authors.affiliation: Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway.
authors.forename: Lasse
authors.initials: L
authors.lastname: Bang
authors.affiliation: Norwegian Childhood Diabetes Registry, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Oslo Diabetes Research Centre, Oslo, Norway.
authors.forename: Torild
authors.initials: T
authors.lastname: Skrivarhaug
authors.affiliation: Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Oslo Diabetes Research Centre, Oslo, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Dahl-Jørgensen
authors.affiliation: Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Institute of Clinical Medicine, Mental Health and Addiction, University of Oslo, Norway.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Rø
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D003927:Diet, Diabetic; D015444:Exercise; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009664:Norway / Q000453:epidemiology; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012737:Sex Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Adolescents; Eating disorders; Eating patterns; Meal frequency; Type 1 diabetes