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Abild CB, Clausen L, Wisting L, Bruun JM, Kristensen K, Støving RK, Vestergaard ET. Screening for disordered eating in adolescents with Type 1 diabetes: A comparison of Diabetes Eating Problem Survey Revised (DEPS-R) and Youth Eating Disorder Examination Questionnaire (YEDE-Q) with item-level analysis. Diabet Med 2025; 42:e15521. [PMID: 39923246 PMCID: PMC12006566 DOI: 10.1111/dme.15521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 01/02/2025] [Accepted: 01/21/2025] [Indexed: 02/11/2025]
Abstract
AIMS People with type 1 diabetes (T1D) face an increased risk of disordered eating (DE) and eating disorders (ED), associated with glucose levels outside target range and an increased risk of complications. The aim of this study was to investigate the type and severity of DE and assess the item accuracy of the Diabetes Eating Problem Survey Revised (DEPS-R) compared to the Youth Eating Disorder Examination Questionnaire (YEDE-Q) in the screening of DE among adolescents with T1D. METHODS Cross-sectional online survey including DEPS-R, YEDE-Q and medical records. Item to total analysis with correlations, and group comparisons were performed. RESULTS A total of 131 adolescents between 11 and 19 (mean age 15.3 ± 2.2) years completed both DEPS-R and YEDE-Q, identifying 21.4% and 22.9% with DE, respectively. Significantly more females (>30%) than males (≈5%) were identified in both measures. More than 50% reported insulin restriction in DEPS-R vs. 1.5% in YEDE-Q. YEDE-Q yielded 32% with weight controlling behaviours, however, half of these were unidentified by DEPS-R. Item-total analysis of DEPS-R showed that item 10 had small correlations to both total score and clinical variables. CONCLUSION This study confirms the clinical relevance of DEPS-R, including associations between DE and female sex, older age, and glucose levels outside target range, however, it may not accurately capture distinct ED risk behaviours, such as excessive exercise or shape and weight related insulin restriction. The item-total analysis shows that the relevance of item 10 should be further investigated.
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Affiliation(s)
- Caroline B. Abild
- Steno Diabetes Center AarhusAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
- Danish National Center for ObesityOsloNorway
| | - Loa Clausen
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
- Department of Child and Adolescent Psychiatry– Research unitAarhus University Hospital, PsychiatryAarhusDenmark
| | - Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Jens Meldgaard Bruun
- Steno Diabetes Center AarhusAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
- Danish National Center for ObesityOsloNorway
| | - Kurt Kristensen
- Steno Diabetes Center AarhusAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Rene Klinkby Støving
- Center for Eating DisordersOdense University HospitalAarhusDenmark
- Research Unit for Medical EndocrinologyOdense University HospitalAarhusDenmark
- Mental Health Services in the Region of SouthernAarhusDenmark
| | - Esben Thyssen Vestergaard
- Steno Diabetes Center AarhusAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
- Pediatric ClinicAarhus University HospitalAarhusDenmark
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Babayeva A, Alishova S, Mammadova G, Coskun M, Cerit ET, Altinova AE, Akturk M, Toruner FB, Karakoc MA, Yalcin MM. Assessment of diabetes-specific eating disorder risk in adult patients with diabetes. J Eat Disord 2025; 13:10. [PMID: 39838500 PMCID: PMC11752928 DOI: 10.1186/s40337-025-01188-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 01/07/2025] [Indexed: 01/23/2025] Open
Abstract
PURPOSE Adults with type 1 diabetes (T1D) are reported to be at higher risk for clinical eating disorders (ED) and other disordered eating behaviors (DEB) than their peers without diabetes. On the other hand, there is insufficient data on DEB in adults with type 2 diabetes (T2D). Our study aimed to investigate the prevalence of DEB in patients with T1D and T2D on intensive insulin therapy followed in our outpatient clinic. METHODS Diabetes Eating Problem Survey-Revised (DEPS-R), electronically delivered to the patients with T1D and T2D who were on an intensive insulin regimen followed up in the diabetes outpatient clinic in our center for the evaluation of DEB. A total of 120 participants, 80 patients with T1D and 40 patients with T2D, were included in the study. DEB was defined as a DEPS-R score ≥ 20 according to the answers given to the questionnaire. RESULTS Risk of DEB was observed in 35% of all individuals with diabetes and was higher in T2D (55% (n = 22)) than in T1D (25% (n = 20)) (p < 0.001). In patients with T1D, BMI was similar between the risk and normal groups in terms of DEB (p = 0.15), whereas in patients with T2D, BMI was significantly higher in the risk group in terms of DEB compared to the non-risk group (p < 0.001). There was a positive correlation between the risk of DEB and HbA1c and a negative correlation with the duration of diabetes in the T1D group (p < 0.05). Weight loss was an important goal for more than 50% of individuals with diabetes in both groups, more than 60% said they skipped a main meal or snack. 13.8% of those with T1D and 27.5% of those with T2D preferred being thin to having their diabetes better controlled. CONCLUSION In our study, 35% of patients with diabetes were found to have a risk of DEB, with the risk being higher in the T2D group. Our results emphasize the importance of increasing awareness among physicians and patients about DEB, which is prevalent among patients with diabetes. Early detection of individuals at risk for DEB should be considered a crucial aspect of treatment.
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Affiliation(s)
- Afruz Babayeva
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | | | | | - Meric Coskun
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Ethem Turgay Cerit
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Alev Eroglu Altinova
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Mujde Akturk
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Fusun Balos Toruner
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Mehmet Ayhan Karakoc
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey
| | - Mehmet Muhittin Yalcin
- Faculty of Medicine, Department of Endocrinology and Metabolism, Gazi University, Ankara, Turkey.
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Lawrence CM, Smart CE, Fatima A, King BR, Lopez P. Increased bolus overrides and lower time in range: Insights into disordered eating revealed by insulin pump metrics and continuous glucose monitor data in Australian adolescents with type 1 diabetes. J Diabetes Complications 2024; 38:108904. [PMID: 39531756 DOI: 10.1016/j.jdiacomp.2024.108904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 09/16/2024] [Accepted: 11/03/2024] [Indexed: 11/16/2024]
Abstract
AIMS To determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB. METHODS 50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed. RESULTS Twenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, p = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, p < 0.002) and BMI Z-score (+1.28 SD vs +0.76 SD, p = 0.040). They had lower time in range, 3.9-10 mmol/L (50.3 % vs. 63.8 %, p = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, p = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, p = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, p < 0.002). CONCLUSIONS DEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.
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Affiliation(s)
- Christopher M Lawrence
- John Hunter Children's Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia.
| | - Carmel E Smart
- John Hunter Children's Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Aleeza Fatima
- John Hunter Children's Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Bruce R King
- John Hunter Children's Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Prudence Lopez
- John Hunter Children's Hospital, Lookout Road, New Lambton Heights, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
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Yang X, Jiang H, Lin M, Yu S, Wu J. The impact of emotion regulation strategies on disordered eating behavior in children and adolescents with type 1 diabetes: a cross-sectional study. Front Pediatr 2024; 12:1400997. [PMID: 39175807 PMCID: PMC11339792 DOI: 10.3389/fped.2024.1400997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/17/2024] [Indexed: 08/24/2024] Open
Abstract
Objective Difficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D. Methods For this cross-sectional study, 128 patients (aged 8-16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs). Results The mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores. Conclusions The prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.
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Affiliation(s)
- Xin Yang
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Hui Jiang
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Meng Lin
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Shuang Yu
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Jin Wu
- Department of Pediatric Genetics, Metabolism and Endocrinology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
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Chou WC, Chou YY, Pan YW, Ou TY, Tsai MC. Correlates of disordered eating and insulin restriction behavior and its association with psychological health in Taiwanese youths with diabetes mellitus. J Eat Disord 2023; 11:158. [PMID: 37710329 PMCID: PMC10503123 DOI: 10.1186/s40337-023-00888-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) with diabetes mellitus (DM) are prone to eating disorders that may worsen metabolic control. This study investigated the clinical and behavioral correlates of disordered eating and insulin restriction (DE/IR) behavior and its association with psychological health among AYAs with DM. METHODS We enrolled patients with DM aged 10-30 years receiving insulin treatment in a tertiary medical center from 2019 to 2021. After obtaining informed consent, we assessed various visit-to-visit HbA1c measures indicating glycemic control, DE/IR behavior using the modified SCOFF questionnaire, weight-control practices (e.g., self-medication, induced vomiting, and over-exercising), and anxious and depressive symptoms using the Hospital Anxiety and Depression Scale. Correlation and hierarchical regression analyses were applied to understand the clinical and behavioral correlates of DE/IR behavior and its association with anxiety and depression. RESULTS Among the 110 patients with type 1 and type 2 DM recruited, we found 17.6% restricting insulin use and 6.3% self-medicating for weight control (higher in type 2 DM than type 1 DM). Hierarchical regression analyses showed HbA1c standard deviation (odds ratio = 2.18, [95% confidence interval 1.07-4.42]), body image (1.83, [1.05-3.20]), and dieting (4.74, [1.70-13.23]) associated with DE/IR behavior. Moreover, DE/IR behavior was further associated with anxiety (1.17 [1.08-1.27]) and depression (1.12 [1.03-1.22]). CONCLUSION DE/IR behavior is not uncommon among AYAs with DM, particularly those with type 2 DM, and may be associated with anxiety and depressive symptoms. In addition, HbA1c variability is correlated with DE/IR behavior, and the clinical implications need further exploration.
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Affiliation(s)
- Wei-Chih Chou
- Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Pediatrics, Shin Huey Shin Hospital, Kaohsiung, Taiwan
| | - Yen-Yin Chou
- Division of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Genomic Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Wen Pan
- Division of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Ying Ou
- Department of Genomic Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Taiwan
| | - Meng-Che Tsai
- Division of Genetics, Endocrinology, and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Genomic Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, 138 Shengli Road, Tainan, 704, Taiwan.
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Atik-Altınok Y, Eliuz-Tipici B, İdiz C, Özgür S, Ok AM, Karşıdağ K. Psychometric properties and factor structure of the diabetes eatıng problem survey- revised (DEPS-R) among adults with type 1 diabetes mellitus. Eat Weight Disord 2023; 28:71. [PMID: 37665472 PMCID: PMC10477092 DOI: 10.1007/s40519-023-01602-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/25/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Although many studies on the Diabetes Eating Problem Survey-Revised (DEPS-R) in adolescents with type 1 diabetes mellitus (T1D), the number of studies validating this questionnaire in adults with T1D is limited. Therefore, this study aimed to examine the factor structure of the Turkish version of the DEPS-R in adults with T1D and internal consistency and construct validity. METHODS A total of 100 patients with T1D, ages 18-50 years, completed the DEPS-R and EDE-Q. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 6-item Turkish version of DEPS-R. RESULTS The Cronbach's alpha coefficient of the DEPS-R Turkish version was 0.77, suggesting good internal consistency. The median (IQ) DEPS-R score was 15.0 (13.0) among all participants. DEPS-R score was significantly correlated with BMI (r = 0.210; p < 0.05) and EDE-Q (r = 0.586; p < 0.01). There was no correlation between the HbA1c values of participants and neither EDE-Q nor DEPS-R scores. The confirmatory factor analysis results show that the three-factor model was a good fit. CONCLUSION A short, self-administered diabetes-specific screening tool for disordered eating behavior is recommended be used routinely in the clinical care of adults with T1D, and Turkish version of DEPS-R has acceptable internal consistency and construct validity in adults with T1D. LEVEL OF EVIDENCE Level V, descriptive study. CLINICALTRIALS gov registration number NCT05346679/ 21.04.2022 (retrospectively registered).
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Affiliation(s)
- Yasemin Atik-Altınok
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Ege University, 35100, Bornova, İzmir, Turkey.
| | - Beyza Eliuz-Tipici
- Division of Pediatric Endocrinology, Department of Pediatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Cemile İdiz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Su Özgür
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ayşe Merve Ok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Kubilay Karşıdağ
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Zhou M, Wang H, Yu J, Luo D, Zhu M, Zhang M, Xu J, Yang T. Diabetes distress and disordered eating behaviors in youth with type 1 diabetes: the mediating role of self-regulatory fatigue and the moderating role of resilience. J Eat Disord 2023; 11:123. [PMID: 37481574 PMCID: PMC10362565 DOI: 10.1186/s40337-023-00838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/28/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Despite previous research on the association between diabetes distress and disordered eating behaviors (DEBs) among youth with type 1 diabetes (T1D), there is a lack of understanding regarding the underlying mechanisms. This study aimed to investigate the relationships between diabetes distress and DEBs, specifically examining whether self-regulatory fatigue mediated the relationship and whether resilience moderated this mediation. METHODS A cross-sectional study was performed among youth with T1D recruited from two diabetes centers in Nanjing, China. Measurement instruments included the problem areas in the diabetes-5 scale, the diabetes strengths and resilience measure for adolescents, the self-regulatory fatigue scale, and the Chinese version of diabetes eating problem survey-revised. Mediation and moderated mediation analyses were conducted. RESULTS A total of 185 youths with T1D were involved in the current study. The results indicated that diabetes distress positively predicted DEBs. Self-regulatory fatigue partially mediated the association between diabetes distress and DEBs, accounting for 50.88% of the overall effect. Additionally, the pathway from self-regulatory fatigue to DEBs was moderated by resilience. CONCLUSION The current study examined whether self-regulatory fatigue mediated the relationship between diabetes distress and DEBs and whether resilience moderated the connection between self-regulatory fatigue and DEBs. These findings add to the theoretical basis of how diabetes distress influences DEBs and help guide the incorporation of diabetes distress, self-regulatory fatigue, and resilience into DEBs reduction programs for youth with T1D.
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Affiliation(s)
- Meijing Zhou
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hong Wang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jian Yu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Nanjing, 210029, China
| | - Min Zhu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Mei Zhang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Jingjing Xu
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
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Lok CW, Wong MC, Yip KW, Ching WK, Choi EKY. Validation of the traditional Chinese version of the diabetes eating problem survey-revised and study of the prevalence of disordered eating patterns in Chinese patients with type 1 DM. BMC Psychiatry 2023; 23:382. [PMID: 37259043 DOI: 10.1186/s12888-023-04744-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/03/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Disordered eating behaviours (DEBs) in patients with type 1 diabetes mellitus (T1DM) are associated with an increased risk of complications and mortality. The Diabetes Eating Problem Survey-Revised (DEPS-R) was developed to screen for DEBs in T1DM patients. The objectives of this study were to develop a traditional Chinese version DEPS-R (electronic version) and to measure the prevalence of DEBs in a local population sample. METHODS The DEPS-R was translated into traditional Chinese, modified and developed into an electronic version. The psychometric properties of the C-DEPS-R were tested on T1DM patients from 15 to 64 years old. The factor structure of the traditional C-DEPS-R was examined by confirmatory factor analysis (CFA). The C-EDE-Q and the C-DES-20 were used for convergent and divergent validity testing, respectively. Module H of the CB-SCID-I/P was used as a diagnostic tool for eating disorders. A correlation study was conducted with the C-DEPS-R scores obtained and the clinical characteristics. Type 2 diabetic (T2DM) patients on insulin treatment were recruited as controls. RESULTS In total, 228 T1DM patients and 58 T2DM patients were recruited. There was good internal consistency of the traditional C-DEPS-R (electronic version), with the McDonald's omega of 0.825 and test-retest reliability of 0.991. A three-factor model of the traditional C-DEPS-R was confirmed by CFA. The cut-off score for the traditional C-DEPS-R was determined to be 24; 13.2% (95% CI 8.8%-17.5%) of T1DM patients were found to score above the cut-off score, while 7.5% (95% CI 4-10.9%) scored above the cut-off by the C-EDE-Q, and 4.4% (95% CI 2.1%-7.9%) were diagnosed with eating disorders by the CB-SCID-I/P Module H. Females with T1DM scored higher on the traditional C-DEPS-R. There was a significant correlation of the C-DEPS-R with BMI, occurrence of DKA, use of a continuous glucose monitoring system and positive diagnosis by the CB-SCID-I/P module H (p < 0.05). CONCLUSION The traditional Chinese-DEPS-R (electronic version) demonstrated good psychometric properties. It is a self-rated, time-efficient and reliable tool for the screening of disordered eating behaviours in T1DM patients in the Chinese population of Hong Kong. Disordered eating behaviours, such as insulin omission, are associated with an increased risk of diabetes mellitus-related complications and mortality. Generic screening tools for eating disorders may over- or underestimate such problems in diabetic patients. Type 1 diabetes mellitus patients are at particular risk of developing disordered eating behaviours or eating disorders, yet studies in Chinese populations are limited. This study developed and validated the traditional Chinese (electronic) version of the Diabetes Eating Problem Survey-Revised (DEPS-R). The traditional Chinese-DEPS-R is a self-rated, time-efficient and reliable tool for the screening of disordered eating behaviours in Type 1 diabetes mellitus patients in the Chinese population of Hong Kong. The study also estimated the prevalence of disordered eating behaviours in diabetic patients from the local Chinese population, and the clinical correlations of the symptoms and clinical parameters were explored. The study reflected a higher prevalence of eating problems in the Type 1 diabetes mellitus population and demonstrated significant correlations of eating problems with BMI as well as the occurrence of diabetic ketoacidosis. Correspondence: lcw891@ha.org.hk.
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Affiliation(s)
- Chi Wing Lok
- Department of Psychiatry, United Christian Hospital, Kowloon, Hong Kong.
| | - Mei Cheung Wong
- Department of Psychiatry, United Christian Hospital, Kowloon, Hong Kong
| | - Kim Wai Yip
- Department of Psychiatry, United Christian Hospital, Kowloon, Hong Kong
| | - Wing Ka Ching
- Department of Psychiatry, United Christian Hospital, Kowloon, Hong Kong
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Tarçın G, Akman H, Güneş Kaya D, Serdengeçti N, İncetahtacı S, Turan H, Doğangün B, Ercan O. Diabetes-specific eating disorder and possible associated psychopathologies in adolescents with type 1 diabetes mellitus. Eat Weight Disord 2023; 28:36. [PMID: 37029851 PMCID: PMC10082703 DOI: 10.1007/s40519-023-01559-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/13/2022] [Indexed: 04/09/2023] Open
Abstract
PURPOSE It was aimed to investigate the frequency of the risk of diabetes-specific eating disorder (DSED) in adolescents with type 1 diabetes mellitus (T1DM) and to reveal the accompanying psychopathologies. METHODS Adolescents with T1DM aged 12-18 who applied to the pediatric diabetes outpatient clinic between July 2021 and March 2022 were included. Diabetes Eating Problem Survey-Revised (DEPS-R) was applied to all patients to determine the risk of DSED. In order to detect accompanying psychopathologies, Eating Disorder Examination Questionnaire (EDE-Q), Child Anxiety and Depression Scale-Child version (RCADS) and Parenting Style Scale were applied. After completing the scales, semi-structured interviews were conducted with all patients by a child and adolescent psychiatrist. RESULTS Ninety-two adolescents (45 boys, 47 girls) were included. DSED risk was found in 23.9% of the cases. A positive correlation was found between DEPS-R and EDE-Q scores (p = 0.001, rho = 0.370). RCADS mean scores were significantly higher in the group with DSED risk (p < 0.001). When the Parenting Style Scale was evaluated, psychological autonomy scores were significantly lower in the group with DSED risk (p = 0.029). As a result of the psychiatric interviews, 30 (32.6%) patients had at least 1 psychiatric disorder. Of these, 2 patients were diagnosed with eating disorder. CONCLUSION Almost one-fourth of adolescents with T1DM were found to be at risk of DSED. Routine screening of adolescents with T1DM with the DEPS-R scale may provide early detection of DSED, and referral of those at risk to child psychiatry enables early diagnosis and intervention for both eating disorders and accompanying psychopathologies. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Gürkan Tarçın
- Department of Pediatric Endocrinology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Hazal Akman
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Didem Güneş Kaya
- Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Nihal Serdengeçti
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Sena İncetahtacı
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Hande Turan
- Department of Pediatric Endocrinology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Oya Ercan
- Department of Pediatric Endocrinology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
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10
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Boccolini G, Marino M, Tiberi V, Iannilli A, Landi G, Grandi S, Tossani E, Cherubini V, ISPED Study Group. A Risk Profile for Disordered Eating Behaviors in Adolescents with Type 1 Diabetes: A Latent Class Analysis Study. Nutrients 2023; 15:nu15071721. [PMID: 37049563 PMCID: PMC10096638 DOI: 10.3390/nu15071721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
(1) Background: This multi-center study aimed to identify a risk profile for disordered eating behaviors (DEBs) in youth with type 1 diabetes (T1D) based on their dietary intake, lipid profile, body mass index (BMI-SDS), and glycometabolic control. (2) Methods: Adolescents aged 11 to 18 years from five centers across Italy were recruited. Lipid profile, HbA1c, BMI-SDS, and dietary intake data were collected. The risk for developing DEBs was assessed via the Diabetes Eating Problems Survey-R (DEPS-R) questionnaire. A latent class analysis (LCA) was performed using a person-centered approach. (3) Results: Overall, 148 participants aged 11–18 (12.1, ±3.34), 52% males with a mean diabetes duration of 7.2 (±3.4), were enrolled. Based on the results of the DEBS-R score, LCA allowed us to highlight two different classes of patients which were defined as “at-risk” and “not at-risk” for DEB. The risk profile for developing DEBs is characterized by higher BMI—SDS (23.9 vs. 18.6), higher HbA1c (7.9 vs. 7.1%), higher LDL cholesterol (99.9 vs. 88.8 mg/dL), lower HDL cholesterol (57.9 vs. 61.3 mg/dL), higher proteins (18.2 vs. 16.1%), and lower carbohydrates (43.9 vs. 45.3%). Adolescents included in the “at-risk” class were significantly older (p = 0.000), and their parents’ SES was significantly lower (p = 0.041). (4) Conclusions: This study allowed us to characterize a risk profile for DEBs based on dietary behavior and clinical parameters. Early identification of the risk for DEBs allows timely intervention and prevention of behavior disorders.
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11
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Hummadi A, Yafei S, Badedi M, Abutaleb R, Darraj H, Alhagawy AJ, Khawaji A, Solan Y, Alzughbi T, Hakami M, Jaddoh S, Daghriri A, Khardali M. Validation of the Arabic Version of Diabetes Eating Problem Survey-Revised (DEPS-R) among Adolescents with Type 1 Diabetes. Nutrients 2023; 15:nu15030561. [PMID: 36771268 PMCID: PMC9919356 DOI: 10.3390/nu15030561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Disordered eating behaviors (DEBs) in type 1 diabetes (T1D) have been studied globally in different age groups. However, there is no validated diabetes-specific questionnaire in the Arabic language for the screening of DEBs. This study aimed to translate the Diabetes Eating Problem Survey-Revised scale (DEPS-R) into the Arabic language and study its psychometric properties in adolescents with T1D. We adopted the forward-backward procedure to translate the DEPS-R questionnaire into Arabic. The validation study enrolled 258 Saudi adolescents with T1D aged 12-18 years who completed the Arabic DEPS-R questionnaire and the EAT-26. The Arabic DEPS-R showed good construct validity and reliability (Cronbach's alpha = 0.86). The factor analysis revealed a three-factor structure of DEPS-R which explains 54.4 % of the variance. In total, 30.6% of the participants are at high risk for DEBs (DEPS-R score ≥ 20). The psychometric properties of the Arabic DEPS-R are satisfactory, consistent with the original scale and translations in other languages. These results support the validity of the Arabic DEPS-R for assessment of DEBs in the T1D Arabic population.
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Affiliation(s)
- Abdulrahman Hummadi
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
- Correspondence: (A.H.); (S.Y.)
| | - Saeed Yafei
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
- Faculty of Medicine and Health Sciences, Taiz University, Taiz P.O. Box 6803, Yemen
- Correspondence: (A.H.); (S.Y.)
| | - Mohammed Badedi
- Administration of Research & Studies, Jazan Health Affairs, Jazan 82611, Saudi Arabia
| | - Raed Abutaleb
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Hussain Darraj
- Administration of Research & Studies, Jazan Health Affairs, Jazan 82611, Saudi Arabia
| | - Ali Jaber Alhagawy
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Abdullah Khawaji
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Yahia Solan
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Turki Alzughbi
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mohammed Hakami
- Psychology Department, Jazan Endocrinology & Diabetes Center, Jazan 82723, Saudi Arabia
| | - Sattam Jaddoh
- Jazan Psychiatry Hospital, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Abdulrraheem Daghriri
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
| | - Mamdouh Khardali
- Jazan Endocrinology & Diabetes Center, Ministry of Health, Jazan 45142, Saudi Arabia
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12
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Oliveira Cunha MCS, Dutra FCS, Cavaleiro Brito LMM, Costa RF, Gaspar MWG, Sousa DF, Moura de Araújo MF, Queiroz MVO. Disordered eating behaviour and eating disorder among adolescents with type 1 diabetes: An integrative review. World J Meta-Anal 2022; 10:244-254. [DOI: 10.13105/wjma.v10.i5.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/26/2022] [Accepted: 10/12/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Type 1 diabetes (DT1) in adolescents brings behavioural changes, altered nutritional habits, and eating disorders.
AIM To identify and analyze the validated instruments that examine the disordered eating behaviour and eating disorders among adolescents with DT1.
METHODS An integrative review was accomplished based on the following databases: PubMed, LILACS, CINAHL, Scopus, Web of Science, and Reference Citation Analysis (RCA), including publications in Portuguese, English, or Spanish, without time limit and time published.
RESULTS The main instruments to evaluate disordered eating behaviour were The Diabetes Eating Problem Survey-Revised, The Diabetes Eating Problem Survey, and the eating attitudes test-26, and for eating disorders the main instruments used were The Bulimic Investigation Test of Edinburgh, The Binge Eating Scale, The Child Eating Disorder Examination, The five questions of the (Sick, Control, One, Fat and Food), and The Mind Youth Questionnaire. These instruments showed an effect in evaluating risks regarding nutritional habits or feeding grievances, with outcomes related to weight control, inadequate use of insulin, and glycaemia unmanageability. We did not identify publication bias.
CONCLUSION Around the world, the most used scale to study the risk of disordered eating behaviour or eating disorder is The Diabetes Eating Problem Survey-Revised. International researchers use this scale to identify high scores in adolescents with DT1 and a relationship with poorer glycemic control and psychological problems related to body image.
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Affiliation(s)
| | | | | | - Rejane Ferreira Costa
- Department of Health Family, Oswaldo Cruz Foundation, Eusébio 61773-272, Ceará, Brazil
| | - Maria Wendiane Gueiros Gaspar
- Department of Health Science, University for the International Integration of Afro-Brazilian Lusophony, Redenção 62790-000, Ceará, Brazil
| | - Danilo Ferreira Sousa
- Department of Nursing, University for the International Integration of Afro-Brazilian Lusophony, Redenção 62790-000, Brazil
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13
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He Y, Liu Q, He Q, Li L. Translation, Adaptation, and Psychometric Testing of the Almere Technology Acceptance Questionnaire (ATAQ) Among Older Adults in China. Clin Interv Aging 2022; 17:1353-1364. [PMID: 36117570 PMCID: PMC9480597 DOI: 10.2147/cia.s367781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background Lack of information on technology Acceptance of Social Assistant robots (SARs) limits the application of robots in the elderly care sector. Currently, no study has not reported a robot acceptance assessment tool in China. Purpose The current study aimed to translate the Almere Technology Acceptance Questionnaire (ATAQ) from English to Mandarin Chinese, perform cross-cultural adaptations, and to evaluate its psychometric properties among elderly people in China. Methods This study was conducted in two phases. Phase 1 comprised the context relevance evaluation, instrument translation, and cultural adaption from English to Mandarin Chinese. Phase 2 involved a quantitative cross-sectional survey of psychometric testing among 317 elderly Chinese, including reliability and evaluation of construct validity. Results In Phase 1, the Context Relevance Index of all items was rated “3 = relevant” or “4 = totally relevant”, and the Translation Validity Index of the 100% items of the ATAQ was rated 3 or 4. The ATAQ-Chinese questionnaire comprised 30 items. In Phase 2, all items of the ATAQ-Chinese questionnaire had a CR above 3 (P<0.001). Correlation coefficients of entries in the current study ranged from 0.403 to 0.763 (P<0.001). Nine factors were extracted through Exploratory Factor Analysis, and the cumulative variance contribution rate was 77.175%. Confirmatory Factor Analysis showed that the model had a good fit (χ2/df=2.006, RMSEA=0.069, RMR=0.059, GFI=0.816, IFI=0.913, TLI=0.896, CFI=0.912). The content validity index was 0.92 indicating that all questions were relevant. The value of Cronbach’s alpha coefficient showed high validity (α= 0.945, 0.664–0.891). The test-retest reliability coefficient was 0.980, indicating that the tool was reliable. Conclusion The Chinese version of ATAQ has good reliability and validity, and it is an acceptable, reliable, and valid tool for determining technology acceptance of Social assistant robots in older adults.
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Affiliation(s)
- Ying He
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Qian Liu
- School of Medicine, Hunan Normal University, Changsha, People's Republic of China
| | - Qiu He
- The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Lun Li
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, People's Republic of China
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14
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Cezar P, Gonçalves RR, Schainberg A, Comim FV, Oliveira SC. Higher score of diabetes eating problem survey-revised (DEPS-R) is associated with poor glycemic control among Brazilian patients with type 1 diabetes (T1DM): A brief report. Diabetes Metab Syndr 2022; 16:102570. [PMID: 35921766 DOI: 10.1016/j.dsx.2022.102570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The diabetes eating problem survey-revised (DEPS-R) questionnaire is a specific and valuable tool for assessing disturbed eating behavior in type 1 diabetes mellitus. The literature suggests an association between a higher DEPS-R score and worse metabolic control; however, these figures have not been described in patients from Latin America. METHODS We evaluated 58 patients with type 1 diabetes mellitus from a Brazilian outpatient clinic using the DEPS-R questionnaire. RESULTS Overall, 23 participants with a high risk for high eating disorder behaviors exhibited significantly increased hemoglobin A1c levels compared with 35 patients with a DEPS-R score <20. CONCLUSIONS Our data support that the presence of a DEPS-R score >20 negatively affects the metabolic control of patients with type 1 diabetes mellitus in Brazil.
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Affiliation(s)
- Patricia Cezar
- Division of Endocrinology, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - Rachel R Gonçalves
- Division of Endocrinology, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - Arnaldo Schainberg
- Division of Endocrinology, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
| | - Fabio V Comim
- Department of Clinical Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Sara C Oliveira
- Division of Endocrinology, Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG), Belo Horizonte, MG, Brazil
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15
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Karastogiannidou C, Giannoulaki P, Samaras I, Kotzakioulafi E, Didangelos T, Bocsan IC, Vassilopoulou E. The Diabetes Eating Problem Survey-Revised (DEPS-R) in a Greek Adult Population with Type 1 Diabetes Mellitus: Model Comparison Supporting a Single Factor Structure. Nutrients 2021; 13:nu13072375. [PMID: 34371885 PMCID: PMC8308548 DOI: 10.3390/nu13072375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/27/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) patients occasionally develop disordered eating behaviors, leading to insulin manipulation without medical consultation, targeting to achieve weight control. In clinical practice, the Diabetes Eating Problem Survey-Revised Version (DEPS-R) questionnaire has been used to evaluate eating disorders in T1DM patients. This study was conducted to validate the factor structure of the Greek version of DEPS-R using Confirmatory Factor Analysis (CFA), to investigate its reliability and convergent validity in Greek T1DM adults and to compare a single factor DEPS-R model with multiple factor models. Participants were 103 T1DM adults receiving insulin, who responded to DEPS-R. Their anthropometric, biochemical and clinical history data were evaluated. The sample presented good glycemic control and 30.1% scored above the established DEPS-R cut-off score for disturbed eating behavior. CFA results revealed that the data fit well to the factor models. The DEPS-R scale had good reliability and was positively linked to BMI, HbA1c, total daily dose and time in range. Model comparison supported the superiority of the 1-factor model, implying that Greek clinicians and practitioners might not have to consider individualized treatment based on various scores across different subscales but they can adopt a single DEPS-R score for an easy and efficient screening for disordered eating.
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Affiliation(s)
- Calliope Karastogiannidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
| | - Parthena Giannoulaki
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Ioannis Samaras
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
| | - Evangelia Kotzakioulafi
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Triantafyllos Didangelos
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, Medical School, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (P.G.); (E.K.); (T.D.)
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania
- Correspondence:
| | - Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (C.K.); (I.S.); (E.V.)
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