背景:在患有1型糖尿病(T1D)的年轻成年人中,饮食紊乱的患病率更高,最终导致发病率和死亡率更高。除了经过验证的糖尿病困扰问卷,抑郁/焦虑症状和情绪健康,糖尿病心理社会评估工具(DPAT)包括三个关于体重舒适度的问题,体形和饮食模式(WSE),这些都来自文献和多学科团队共识。识别对WSE舒适度较低的个人,是确定那些可能有饮食失调风险的人的第一步。
目标:观察WSE的舒适度,在患有T1D的年轻人中,及其与人口统计学/临床特征和心理参数的关联。
方法:276名年轻人,15-26岁,在年轻成人糖尿病诊所接受常规临床护理,完成了DPAT。WSE问题以5分Likert量表进行评分(1表示最低舒适度)。线性回归通过人口统计学和心理参数分析了体重和饮食方式的舒适度差异。
结果:3名年轻人中的1名(29%)报告对WSE的舒适度较低(得分1或2)。在女性中,40%,41%和35%的人对体重的舒适度较低,形状和饮食模式,与男性相比,这是18.5%,16%和21.5%。女性报告的体重和饮食方式的舒适度(分别为2.9和3.0)低于男性(分别为3.7和3.6),每个p<0.001。体重(p<0.001)和饮食模式(p=0.001)的舒适度较低与较高的体重指数(BMI)相关。体重和饮食习惯较低的年轻人经历了糖尿病困扰和抑郁/焦虑症状的升高(每个p<0.001),当调整性别和BMI时。
结论:研究表明,WSE的低舒适度在患有T1D的年轻成年人中很常见。将这些问题添加到日常护理中,可以允许容易和早期识别低舒适度,启动治疗性对话和实施重点管理战略。
与没有糖尿病的同龄人相比,患有1型糖尿病(T1D)的年轻人饮食紊乱(DE)的发生率更高。DE发生在关于体重的轻度扭曲的思想和行为的频谱上,形状和饮食的思想和行为,医学和心理健康后果不符合饮食失调的正式诊断标准。T1D中DE的早期筛查不是常规进行的,因此通常未被发现。由于情况的严重性,识别是关键。糖尿病心理社会评估工具旨在每年评估患有T1D的年轻人(≥16岁)的社会心理健康,其中包括三个关于体重舒适度的问题。形状和饮食模式(WSE)。1/3的T1D年轻人报告WSE的舒适度较低。体重和饮食方式的较低舒适度与女性和较高的体重指数有关。低舒适度与体重和饮食习惯与糖尿病困扰和抑郁/焦虑症状之间有很强的关系。在调整性别和体重指数后。因此,纳入WSE问题对于早期识别可能存在进食障碍风险的T1D年轻成人很有价值.
BACKGROUND: Higher prevalence of disordered eating in young adults with type 1 diabetes (T1D) culminates in higher levels of morbidity and mortality. In addition to validated questionnaires for diabetes distress, depression/anxiety symptoms and emotional well-being, the Diabetes Psychosocial Assessment Tool (DPAT) includes three questions about comfort with weight, body shape and eating pattern (WSE), which were derived from literature and multidisciplinary team consensus. Recognising individuals with low comfort with WSE, is the first step towards identifying those who may be at risk of developing eating disorders.
OBJECTIVE: Observe comfort with WSE, in young adults with T1D, and its associations with demographic/clinical characteristics and psychological parameters.
METHODS: 276 young adults, aged 15-26, who attended routine clinical care at a Young Adult Diabetes Clinic, completed the DPAT. The WSE questions were scored on a 5-point Likert scale (1 indicating lowest comfort). Linear regression analysed differences in comfort with weight and eating pattern by demographic and psychological parameters.
RESULTS: 1 in 3 young adults (29%) reported low comfort with WSE (scores 1 or 2). In females, 40%, 41% and 35% had low comfort with weight, shape and eating patterns respectively, in comparison to males in whom it was 18.5%, 16% and 21.5%. Females reported lower comfort with weight and eating pattern (mean 2.9 and 3.0 respectively) than Males (mean 3.7 and 3.6 respectively), each p < 0.001. Lower comfort with weight (p < 0.001) and eating pattern (p = 0.001) was associated with higher body mass index (BMI). Young adults with low comfort with weight and eating pattern experienced elevated diabetes distress and depressive/anxiety symptoms (each p < 0.001), also when adjusted for sex and BMI.
CONCLUSIONS: The study has shown that low comfort with WSE is common among young adults with T1D. Adding these questions into routine care, can allow for easy and early identification of low comfort, initiation of a therapeutic dialogue and implementation of focused management strategies.
There is a higher rate of disordered eating (DE) in young adults with type 1 diabetes (T1D) compared to their peers without diabetes. DE occurs on a spectrum from mildly distorted thoughts and behaviours regarding weight, shape and eating to thoughts and behaviours with medical and mental health consequences that do not meet formal diagnostic criteria for an eating disorder. Early screening for DE in T1D is not routinely performed and therefore often remains undetected. Due to the seriousness of the conditions, identification is key. The Diabetes Psychosocial Assessment Tool was developed to annually assess psychosocial well-being of young adults (≥ 16 years) with T1D and includes three questions about comfort with weight, shape and eating pattern (WSE). 1 in 3 young adults with T1D reported low comfort with WSE. Lower comfort with weight and eating pattern was associated with females and with higher body mass index. There was a strong relationship between low comfort with weight and eating pattern and diabetes distress and depressive/anxiety symptoms, after adjusting for sex and body mass index. Hence, inclusion of the WSE questions is valuable for early identification of young adults with T1D who may be at risk for an eating disorder.