Risk behaviors for eating disorder in adolescents and adults with type 1 diabetes

Objective: To evaluate the frequency of risk behaviors for eating disorder (ED) in patients with type 1 diabetes (T1D) and their association with gender, nutritional status, variables related to T1D, and body satisfaction. Method: 189 individuals with T1D (12-56 years old) answered the Bulimic Investigation Test (BITE), the Eating Attitude Test (EAT), the Binge Eating Scale (BES), Stunkard's Figure Rating Scale, and questions regarding control of T1D. Association between ED risk behaviors and the selected variables was assessed with the chi-square test and Student's t-test; factors that influenced the risk of ED were identified by means of logistic regression. Results: Of the patients with T1D, 58.7% were at risk of ED (45, 40, and 16% according to the EAT, BITE and BES, respectively). There were significant differences between groups with and without risk for ED related to BMI (p = 0.009), gender (p = 0.001), insulin omission (p = 0.003), use of the carbohydrate counting method (p = 0.019), and body dissatisfaction (p = 0.001). The risk of ED was nine times higher in patients who reduced or omitted insulin (p = 0.036). Conclusions: Patients with T1D demonstrated a high frequency of body dissatisfaction and ED risk behaviors; the omission or reduction of insulin was an important risk factor.