Background: Adolescents with type1 diabetes appear to be at greater risk for developing eating disorders (ED) which are often associated with impaired metabolic control of diabetes.
Aim: To estimate the prevalence of ED in a population of adolescents with type 1 diabetes (T1D) and to identify risk factors associated with this disorder in order to propose preventive measures.
Methods: A cross-sectional, population-based study involved 102 adolescents with type 1 diabetes, aged 11-18 years, recruited from the National Institute of Nutrition in Tunis, Tunisia over a period of one-year January 2017-January 2018.
Results: The prevalence of ED was 33.3%. It was significantly higher among girls (46.2% vs 20%, p = 0.005). Unspecified ED were predominant with a prevalence of 29.4%. Independent factors associated with ED were female sex, abdominal obesity and quality of life. The risk of developing ED was multiplied by 3.5 for women (adjusted OR = 3.5 and CI95% [1.4-8.6]) and by 5.6 for patients with abdominal obesity (Adjusted OR = 5.6 and CI95% [1.5-20.4]). Impaired quality of life and specifically anxiety about diabetes increased significantly the risk of developing ED in our patients. However, we didn't find significant association between ED and age, family characteristics, duration of diabetes, metabolic balance, treatment and complications of diabetes.
Conclusion: We concluded that ED should be always suspected in adolescents with T1D especially in girls. Unspecified ED are more common in this group of patients. Treatment of diabetes requires a multidisciplinary care approach including diabetologist, dietician and psychiatrist in order to promote healthy eating and to improve quality of life of adolescents with T1D.