Disordered Eating Behaviours and Associated Factors Among People With Type 1 Diabetes: A Cross-Sectional Study in...

People with type 1 diabetes mellitus (T1D) are at increased risk of disordered eating behaviours (DEBs), partly due to aspects of diabetes management. The aim of this study was to estimate the prevalence of DEBs in a group of adults with T1D in Spain and to examine their association with sociodemographic, clinical, and lifestyle-related factors.

A nationwide cross-sectional study was conducted as part of the D1ANAS project, involving 451 people aged ≥ 16 years with T1D living in Spain. DEBs were assessed using the validated Spanish version of the Diabetes Eating Problems Survey-Revised (DEPS-R), with scores ≥ 20 indicating a positive screening. Sociodemographic, clinical, and lifestyle variables were collected using a self-administered online questionnaire. Multivariate linear regression analyses were performed to identify factors independently associated with the total DEPS-R score.

The mean DEPS-R score was 16.8 (SD 12.1), and 31.7% of participants screened positive for DEBs, with higher prevalence in women than men (35.4% vs. 14.8%, p < 0.001) 36.6% of participants reported insulin restriction behaviours, with no significant differences between sexes. In the adjusted models, female sex (β = 3.23, 95% CI = 0.65-5.82), higher HbA1c percentage (β = 2.12, 95% CI = 1.32-2.93), and higher zBMI (β = 3.44, 95% CI = 2.44-4.44) were independently associated with higher DEPS-R scores, as were poorer perceived health (β = 5.11, 95% CI = 2.25-7.96), poorer diet quality (β = 13.42, 95% CI = 7.23-19.61) and poor sleep perception (β = 3.43, 95% CI = 1.46-5.39). The model explained 29.6% of the variance in DEPS-R scores.

DEBs affect about one-third of the participants with T1D and are associated with poorer metabolic control, higher BMI, and adverse lifestyle and psychosocial factors, highlighting the need for diabetes-specific screening and multidisciplinary management.