Diagnosis of type 1 diabetes mellitus triples the odds of screening positive for eating disorders: A case-control study

Table 1 Characteristics of the sample (n = 110 children and adolescents), mean ± SD, n (%)

Girls/boys	51 (46.4)/59 (53.6)
Age (years)	11.8 ± 3.3
Diagnosis (short stature/T1DM)	55 (50)/55 (50)
Duration of diagnosis (years)	6.7 ± 3.2
Body weight (kg)	43.7 ± 19.4
Stature (cm)	145.4 ± 18.7
Tanner stage for pubic hair (I/II/III/IV/V)	21.5%/22.4%/11.2%/12.1%/32.7%

T1DM: Type 1 diabetes mellitus.

Table 2 Comparison of anthropometric indices and G-SCOFF results between children and adolescents with type 1 diabetes mellitus (n = 55) vs children with short stature (n = 55), n (%)

	Total (n = 110)	T1DM (n = 55)	Short stature (n = 55)	Significance1
WAZ	0.09 ± 1.59	1.2 ± 1.0	-0.75 ± 1.4	< 0.001
HAZ	-0.37 ± 1.27	0.51 ± 1.0	-1.25 ± 0.8	< 0.001
BMIz	0.40 ± 1.34	0.76 ± 1.2	0.04 ± 1.4	0.005
Underweight	9 (8.2)	1 (1.8)	8 (14.5)	0.049
Normoweight	69 (62.7)	34 (61.8)	35 (63.6)
Overweight	19 (17.3)	11 (20)	8 (14.5)
Obese	13 (11.8)	9 (16.4)	4 (7.3)
HbA1%	5.7 (2.2)	7.4 (1.2)	5.2 (0.4)	< 0.001
AGR (cm/year)	5.6 ± 2.9	4.4 ± 3.1	6.6 ± 2.3	< 0.001
SCOFF (1-5)	1.0 (1.0)	2.0 (1.0)	1.0 (1.0)	0.006
FED positive	50 (45.5)	33 (60)	17 (30.9)	0.002

¹Categorical variables are presented as counts (n) and percentages (%) or otherwise stated.

Normally continuous variables are presented as mean ± SD and as median and interquartile range for non-normally distributed variables. P values derived from Student’s t test and Mann-Whitney U test, for the normally and for the non-normally distributed continuous variables, respectively. P value for categorical variables derived from χ² tests. AGR: Annual growth rate; BMIz: Body mass index z-score; HAZ: Height-for-age z-score; HbA1c: Glycosylated haemoglobin; WAZ: Weight-for-age z-score; FED: Feeding and eating disorder; FED positive: Feeding and eating disorder positive [i.e., participants with a positive G-SCOFF screen (≥ 2 “yes” responses) indicating suspicion of an eating disorder but not a confirmed diagnosis]; T1DM: Type 1 diabetes mellitus.

Table 3 Comparison of the dietary intake between children and adolescents with type 1 diabetes mellitus (n = 55) vs children with short stature (n = 55), n (%)

Nutrients		Total (n = 110)	T1DM (n = 55)	Short stature (n = 55)	Significance
Energy	Energy (kcal/day)	1576 (709)	1533 (736)	1659 (719)	0.41
Macronutri-ents	Carbohydrates (g/day)	189 (89)	196 (103)	181 (80)	0.54
	Proteins (g/day)	65 (36)	63 (35)	65 (39)	0.45
	Sugars (g/day)	55 (44)	54 (43)	56 (51)	0.62
	Dietary fiber (g/day)	14.9 (10.4)	16 (12)	12 (9.0)	0.08
	Total fats (g/day)	67 (46)	66 (41)	74 (43)	0.12
Fatty acids	MUFA (g/day)	23 (21)	22 (16)	24 (25)	0.11
	PUFA (g/day)	10.5 (9.7)	9.9 (9.3)	11 (10.4)	0.58
	SFA (g/day)	23 (16)	22 (18)	24 (15)	0.24
	Trans-fatty-acids (g/day)	0.85 (0.9)	0.8 (0.7)	1.1 (0.9)	0.09
	Cholesterol (g/day)	179 (207)	170 (221)	179 (195)	0.54
	n-3 fatty acids (g/day)	1.1 (1.0)	1.1 (0.9)	1.2 (1.0)	0.38
Amino-acids	Isoleucine (g/day)	2.25 (1.8)	2.2 (1.6)	2.45 (1.9)	0.47
	Leucine (g/day)	4.1 (2.8)	4.0 (2.8)	4.3 (3.5)	0.44
	Methionine (g/day)	1.15 (1.0)	1.1 (0.8)	1.2 (1.0)	0.44
	Phenylalanine (g/day)	2.35 (1.6)	2.3 (1.5)	2.5 (1.9)	0.61
	Tryptophan (g/day)	0.6 (0.5)	0.6 (0.4)	0.6 (0.5)	0.53
	Valine (g/day)	2.6 (2.0)	2.6 (1.7)	2.85 (2.2)	0.58
Vitamins	Vitamin B12 (μg/day)	2.9 (2.5)	3.0 (2.5)	2.8 (2.4)	0.98
	Folic acid (μg/day)	376 (262)	370 (272)	388 (266)	0.99
	Vitamin A (μg/day)	295 (300)	312 (299)	262 (270)	0.38
	Vitamin C (mg/day)	30.5 (54)	31 (51)	29.4 (62)	0.92
	Vitamin D (IU/day)	126 (161)	131 (180)	124 (143)	0.64
	Vitamin E (mg/day)	6.15 (6.2)	5.8 (5.6)	6.8 (6.8)	0.42
	Vitamin K (μg/day)	36 (59)	36 (88)	36 (49)	0.38
Minerals	Calcium (mg/day)	758 (544)	790 (538)	739 (555)	0.72
	Copper (mg/day)	0.8 (0.5)	0.85 (0.6)	0.7 (0.5)	0.13
	Iron (mg/day)	11.3 (6.9)	12.2 (7.2)	9.9 (6.9)	0.48
	Phosphorus (mg/day)	886 (470)	872 (449)	902 (542)	0.85
	Potassium (mg/day)	1879 (1054)	1860 (1050)	1890 (1001)	0.93
	Sodium (mg/day)	1999 (1254)	1954 (1049)	2084 (1456)	0.22
	Zinc (mg/day)	6.7 (4.7)	6.8 (3.7)	6.7 (6.4)	0.73

Results are presented as median and interquartile range. P values derived from Mann-Whitney test. MUFA: Mono-unsaturated fatty acids; PUFA: Poly-unsaturated fatty acids; SFA: Saturated fatty acids; T1DM: Type 1 diabetes mellitus.

Table 4 Results from logistic regression models evaluating the association between children’s diagnosis (type 1 diabetes mellitus vs short stature) and the screening positive for feeding and eating disorders

	Crude model			Age & sex adjustment			Full adjustment
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
Diagnosis (T1DM vs short stature)	3.35	1.53-7.36	0.003	2.74	1.21-6.2	0.016	3.15	1.33-7.46	0.009
Age (years)				1.10	0.97-1.25	0.13	1.36	1.03-1.79	0.03
Sex (male/female)				0.49	0.21-1.1	0.09	0.42	0.16-1.07	0.07
Weight status							0.89	0.57-1.39	0.61
Tanner’s stage of pubic hair (I-V)							0.61	0.34-1.09	0.10
Energy intake (kcal/day)							1.00	0.99-1.00	0.32

FEDs: Feeding and eating disorders [participants with a positive G-SCOFF screen (≥ 2 “yes” responses), indicating suspicion of an eating disorder but not a confirmed diagnosis]. T1DM: Type 1 diabetes mellitus.