Type 1 diabetes (T1D) can be a difficult condition to manage. Individuals must continuously be aware of their food and beverage intake, physical activity, overall health, and how this impacts their blood sugar. They must regularly check their blood glucose levels and administer appropriate doses of insulin as necessary.
Managing T1D combined with disordered eating can present even more challenges. Inconsistencies in food intake and negative feelings about eating and using insulin can make it harder to stay within a target blood sugar range. A recent study involving 23 women found that the time spent in level 2 hyperglycemia – blood sugar greater than 250 mg/dL – may be four times longer in individuals with T1D who also have disordered eating compared to those with only T1D.
Participants were divided into two groups: 13 women with T1D and disordered eating, and 10 women with T1D only. All participants were asked to keep a diabetes diary using a smartphone app to record information about their meals, insulin usage, and any emotions or behaviors related to the meal, such as binge eating or skipping insulin. Each woman tested her own blood sugar before meals and at bedtime, but they also wore a blinded continuous glucose monitor (CGM).
In addition, all participants completed a variety of surveys and screenings and engaged in a semi-structured interview with a clinical psychologist with expertise in disordered eating. Results were recorded for the Diabetes Eating Problem Survey-Revised, the Diabetes Distress Screening Scale, the Patient Health Questionnaire-9, and the Yale Food Addiction Scale.
Women in the disordered eating cohort showed higher use of recreational drugs, higher mean HbA1c levels, and higher scores on the diabetes distress, depression, and diabetes eating problem surveys than the control group. Furthermore, the disordered eating group reported more negative emotions and tested their blood sugar levels less frequently.
When looking at hyperglycemia, “the disordered eating group had a mean serum glucose of greater than 10 mmol/L (180 mg/dL) for 49.8% of the study period, whereas the control cohort spent 25.6% of time above range.” When narrowing it down to level 2 hyperglycemia specifically, “the disorder eating group was above range 21.3% of the time vs. 5% for the control group.”
Given that individuals must make significant changes to their lives when diagnosed with type 1 diabetes, it may be beneficial to provide additional support around diabetes self-care and mental health to reduce risk of developing disordered eating as well. Early introduction of healthy strategies and habits for managing diabetes, along with psychological support, may help improve glucose control.
Providing individuals with the knowledge, training, and support necessary for effectively managing type 1 diabetes is essential. The Diabetes Research Connection (DRC) is committed to enhancing research capabilities by providing critical funding for early-career scientists focused on diagnosis, prevention, and management of T1D, as well as finding a cure. Learn more by visiting https://diabetesresearchconnection.org.
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